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CI-523-04 CARDIAC RESYNCHRONIZATION THERAPY USING THE SYNCAV ALGORITHM COMPARED TO CONVENTIONAL BIV PACING: PRELIMINARY RESULTS OF THE DOUBLE-BLIND, RANDOMIZED, MULTICENTER CLINICAL TRIAL "CRUSTY-TRIAL"

      Background

      Some of the devices for cardiac resynchronization therapy (CRT) have automatic algorithms to achieve ventricular fusion, such as the SyncAVTM algorithm (Abbott). There are few data on the possible clinical benefit of its use in clinical practice.

      Objective

      To assess whether cardiac resynchronization using the SyncAVTM algorithm achieves greater electrical resynchronization compared to a conventional biventricular pacing (CVP).

      Methods

      The CRUSTY trial is a multicenter, randomized, double-blind clinical trial to evaluate the superiority of CRT with fusion using the SyncAVTM algorithm over CVP (with optimization of AV and VV intervals) with a 6-month follow-up. (ClinicalTrials.gov Identifier: NCT03961399). This sub-study focuses on the data obtained at the inclusion and baseline visit to assess the acute electrical response.

      Results

      From January 2019 to April 2021, 54 patients were included in the 15 participating centers (mean age 66 ± 9 years, 40% women). After 1: 1 randomization (Figure 1A), no significant differences were observed in their baseline characteristics (TABLE). After resynchronization, the duration of paced QRS in SyncAV group was lower (137 ± 4 MS VS 118 ± 17 ms, p <0.01), as well as the absolute (deltaQRS) and relative (% deltaQRS) reduction of the QRS (29 ± 23 ms Vs 52 ± 19ms, p <0.01; 17% vs 30%, p <0.01 respectively) (FIGURE). The number of “super-resynchronizers” (QRS <120ms) was higher in the SyncAV group (19% vs 63%, p <0.01). In the multivariate analysis, the use of the SyncAV TM algorithm was the only factor that predicted a “super-resynchronizer” response type (OR 7.8; 95% CI 2-26)