P416Six-month biventricular crt response with a quadripolar crt system in the more response on cardiac resynchronization Therapy with multipoint pacing (MORE -CRT MPP) trial
Bibliographic record
Abstract
Funding Acknowledgements: Abbott Background: Prior studies demonstrate cardiac resynchronization therapy (CRT) with MultiPoint Pacing (MPP) improves left ventricular (LV) reverse remodeling and clinical response compared to biventricular (BiV) pacing. Purpose: The MORE-CRT MPP trial is a prospective, randomized, multi-center trial to assess the impact of activating MPP using two LV pacing vectors from a single quadripolar LV lead in patients who do not respond to 6 months of BiV pacing. This abstract reports the initial results assessing the non-responder (NR) rate in patients treated with BiV pacing over the first 6 months of the trial. Methods: A total of 2379 out of 3796 patients are enrolled in the trial and implanted with a quadripolar CRT system with MPP (Abbott). Quadripolar, BiV pacing is activated at implant and continued through 6 months of follow-up. An echocardiogram is completed at baseline and 6 months to assess non-response to BiV pacing (<15% reduction in left ventricular end systolic volume (LVESV)). After 6 months, patients classified as NRs are randomized to receive MPP or continued BiV therapy for an additional 6 months. Once all patients complete 12 months of follow-up, the two groups will be compared to assess differences in CRT response rate. Results: A total of 1391 patients (36.6%) have completed 6 months of follow-up and had baseline and 6-month echocardiograms reviewed by an independent core lab. The average patient age is 67±10 years, with 72% male. Average patient baseline characteristics include QRS duration of 159 ± 25 ms, LVEF of 26 ± 7% and LVESV of 159 ± 66. A majority of patients (97.4%) had NYHA class II/III heart failure with 42.8% of the patients having ischemic heart disease. A total of 94.6% of patients received a CRT-D system. At 6 months, 561/1391 (40.3%) of patients were classified as NRs to BiV pacing based on independent core lab assessment of LVESV. The NR rate by device type is 41% for CRT-D and 33% for CRT-P devices (p=0.20). Among ischemic patients, the NR rate is 51% and in non-ischemic patients, the NR rate is 32% (p<0.001). Conclusion: The 6-month NR rate of 40% based on independent assessment of LVESV is similar to that reported in other CRT studies. Further data is being collected and assessed to compare 12-month CRT response rates between NR patients randomized to 6 months of MPP or continued BiV therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".