The rationale and design of the SMART CRT trial.

Abstract: Aims: The SMART CRT study will assess the efficacy of an atrioventricular optimization algorithm to improve reverse remodeling among patients undergoing cardiac resynchronization therapy (CRT) in the presence of interventricular electrical delay. Methods and results: The SMART CRT study is...

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Published in:Pacing & Clinical Electrophysiology Vol. 41; no. 9; pp. 1212 - 1217
Main Authors: Gold, Michael R., Auricchio, Angelo, Leclercq, Christophe, Lowy, Jonathan, Rials, Seth J., Shoda, Morio, Tomassoni, Gery, Yong, Patrick, Wold, Nicholas, Ellenbogen, Kenneth A.
Format: research tables/charts randomized controlled trial Journal Article
Published: Wiley-Blackwell Sep2018
Online Access:View this record in EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: The rationale and design of the SMART CRT trial.
      aug:
        au:
          Gold, Michael R.
          Auricchio, Angelo
          Leclercq, Christophe
          Lowy, Jonathan
          Rials, Seth J.
          Shoda, Morio
          Tomassoni, Gery
          Yong, Patrick
          Wold, Nicholas
          Ellenbogen, Kenneth A.
        affil: Department of Medicine, Medical University of South Carolina, SC, USA
      sug:
        subj:
          Cardiac Resynchronization Therapy Methods
          Ventricular Remodeling
          Bundle-Branch Block Therapy
          Human
          Randomized Controlled Trials
          Algorithms
          Treatment Outcomes
          Multicenter Studies
          Prospective Studies
          Stroke Volume
          Heart Failure Mortality
          Quality of Life
          Clinical Assessment Tools
          Questionnaires
          Ventricular Ejection Fraction
          Electrodes, Implanted
          Heart Ventricle, Right Surgery
          Heart Ventricle, Left Surgery
          Cardiac Pacing, Artificial
      ab: Abstract: Aims: The SMART CRT study will assess the efficacy of an atrioventricular optimization algorithm to improve reverse remodeling among patients undergoing cardiac resynchronization therapy (CRT) in the presence of interventricular electrical delay. Methods and results: The SMART CRT study is a global, multicenter, prospective, randomized study of patients undergoing CRT implantation. The primary endpoint of this trial is response rate to CRT, defined as decrease in left ventricular end‐systolic volume (LVESV) ≥15% at 6 months compared to preimplant baseline. Additional prespecified analyses are: (1) clinical composite endpoint combining all‐cause mortality, heart failure events, New York Heart Association class, and Quality of Life (using a patient global assessment instrument); (2) the individual components of the clinical composite endpoint; (3) 6‐minute walk distance; (4) Kansas City Cardiomyopathy Questionnaire; (5) LVESV as a continuous variable; and (6) absolute left‐ventricular ejection fraction. Subjects with intraventricular delay ≥ 70 ms measured between the right ventricular and left ventricular pacing leads will be randomized in a 1:1 ratio to have either an AV Delay and pacing chamber determined by SmartDelay™ or a Fixed AV Delay of 120 ms with biventricular pacing. Enrollment of an estimated 726 of subjects from up to 100 centers worldwide is planned to achieve 436 randomized subjects and 370 complete data sets required to power the primary endpoint. Conclusions: This trial will provide important data regarding the importance of AV Delay programming in patients with prolonged interventricular delay at the pacing sites.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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