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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".