News | Cardiac Resynchronization Therapy Devices (CRT) | August 30, 2016

Medtronic Pacing Algorithm Improves Delivery of Cardiac Resynchronization Therapy

Data on EffectivCRT for heart failure patients with atrial fibrillation presented at ESC

August 30, 2016 — Medtronic plc announced results from the Cardiac Resynchronization Therapy Efficacy Enhancement (CRTee) study at the 2016 European Society of Cardiology (ESC) Congress in Rome. The study showed that the Medtronic-exclusive device-based EffectivCRT during AF algorithm improves therapy delivery in heart failure patients with atrial fibrillation (AF).

Current CRT devices report "percent pacing" — a measure of whether the device sends a pacing pulse to stimulate the heart. However, current devices do not report the effectiveness of each pacing stimulus — that is, whether the pacing pulse "captures" the heart muscle and improves its pumping ability.

The new EffectivCRT during AF feature automatically determines the effectiveness of each left ventricular pace and adjusts pacing rates during AF. This is important for heart failure patients suffering from AF, because the pacing pulse from the device is more likely to be ineffective or interrupted because of this irregular heart rhythm.

"This technology brings us one step closer to understanding effective left ventricular pacing for AF patients receiving CRT, which has been difficult to manage in the past" said Suneet Mittal, M.D., director, electrophysiology laboratory, Arrhythmia Institute of the Valley Health System, Ridgewood, N.J. "We can now optimize treatment to a larger patient base, including difficult-to-treat non-responders, to hopefully prevent patients from undergoing additional treatments and often invasive follow-on procedures."

The EffectivCRT Diagnostic and EffectivCRT during AF algorithm are available on the Claria MRI Quad CRT-D SureScan in Europe.

The EffectivCRT features are investigational only in the United States; the Claria CRT-D is not approved for sale in the U.S.

The Claria device, which is approved for full-body magnetic resonance imaging (MRI) scans in 1.5 and 3T machines, can be paired with Attain Performa quadripolar lead technology. In addition to the new EffectivCRT features, the Claria device includes the Medtronic-exclusive AdaptivCRT algorithm, which has been shown to provide a 46 percent reduction in AF risk1 and reduce a patient's odds of a 30-day heart failure readmission by 59 percent2.

CRTee was a prospective, randomized, crossover study of 71 patients with paroxysmal, persistent or permanent AF. Sixty-six patients were randomized first to either an existing algorithm or the new EffectivCRT algorithm, with the desired outcome of a higher percent of effective CRT being delivered during AF. Fifty-four patients completed both arms. The EffectivCRT group increased effective pacing during AF by 7 percent, from 81 percent to 88 percent, p<0.001. Heart rate increased by only three beats-per-minute, from 77 to 80 BPM, p<0.001. Patients with a low percent of pacing at baseline (less than or equal to 80 percent) received the greatest benefit (average absolute increase of 15 percent effective pacing).

For more information:

1 Martin DO, et al. Clinical Outcomes with Adaptive Cardiac Resynchronization Therapy: Long-Term Outcomes of the Adaptive CRT Trial. HFSA Late Breakers. September 23, 2013.
2 Starling RC, Krum H, Bril S, et al. Impact of a Novel Adaptive Optimization Algorithm on 30-Day Readmissions: Evidence From the Adaptive CRT Trial. JACC Heart Fail. July 2015;3(7):565-572.

Related Content

Boston Scientific's Apama multi-electrode ablation balloon to treat atrial fibrillation.

Boston Scientific's Apama multi-electrode ablation balloon to treat atrial fibrillation. The technology allows different energies to be used for each electrode to prevent damage to the esophagus or other underlying critical structures. 

Feature | Atrial Fibrillation | January 15, 2018 | Dave Fornell
The development of atrial fibrillation (AFib or AF) ablation technologies over the past 20 years has been a constant
Heart Rhythm Society Partners With WebMD Education to Increase Atrial Fibrillation Awareness
News | Atrial Fibrillation | January 02, 2018
The Heart Rhythm Society (HRS), in partnership with WebMD Education, announced in December the launch of a free, online...
The Boston Scientific Rhythmia Mapping System produces higher-density voltage maps without increasing overall procedure time.

The Boston Scientific Rhythmia Mapping System produces higher-density voltage maps without increasing overall procedure time. It was the first of a new generation of high-density mapping systems to be introduced.

Feature | Atrial Fibrillation | December 18, 2017 | Kenneth Stein, M.D. FACC FHRS
When I began practicing as an electrophysiologist in 1994, the dream of successfully using cardiac catheter ablation
Acutus dipole density EP mapping for ablation procedures.

The FDA recently cleared high-speed Acutus Medical's AcQMap High Resolution image and mapping system and the AcQMap 3-D Imaging and Mapping Catheter.  detects and displays both standard voltage-based and higher resolution dipole density (charge-source) maps. The system combines ultrasound anatomy construction with an ability to map the electrical-conduction of each heartbeat to identify complex arrhythmias across the entire atrial chamber. Following each ablation treatment, the heart can be re-mapped in seconds to continually visualize any changes from the prior mapping.



Feature | Atrial Fibrillation | November 07, 2017
November 7, 2017 — Here is an aggregated list of articles detailing the latest clinical data and new device technolog
The Watchman LAA occluder PREVAIL Trial 5-year results were presented at the 2017 TCT meeting.
Feature | Atrial Fibrillation | November 02, 2017
November 2, 2017 – Five-year results from the PREVAIL Trial comparing left atrial appendage closure (LAAC) with the B
UNC School of Medicine Receives $1.7 Million for Atrial Fibrillation Program Streamlining Patient Care
News | Atrial Fibrillation | October 23, 2017
October 23, 2017 — University of North Carolina (UNC) School of Medicine cardiologist Anil Gehi, M.D., will use a $1.
EMANATE Trial Shows Apixaban Lowers stroke in AF Patients Undergoing Cardioversion.
News | Atrial Fibrillation | September 01, 2017
September 1, 2017 — Apixaban lowers the risk of stroke compared to warfarin in anticoagulation-naïve patients with at
CASTLE-AF Study shows Catheter Ablation of Atrial Fibrillation is First-Line Treatment for Heart Failure Patients. Biotronic Ilivia 7 ICD.

The CASTLE-AF Study shows catheter alation of AF can be used effectively to treat heart failure in patients with an implanted ICD.

News | Atrial Fibrillation | September 01, 2017
September 1, 2017 — Final results from the CASTLE-AF study show a 38 percent reduction in the composite of all-cause
Overlay Init