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

An example of the new generation of cardiac monitoring device that is replacing Holter monitoring is the Cardea Solo wearable sensor. The FDA-cleared device automatically analyzes data when the device is turned back into the physician's office and automatically produces a draft summary report. This technology can simplify the workflow by eliminating the need for third-party involvement.

Feature | Atrial Fibrillation | September 13, 2018
Rapid advances in technology to monitor atrial fibrillation (AF or Afib) are enabling clinicians to access real-time
Atrial Fibrillation Patients Diagnosed With Carotid Atery Disease Face Increased Risk of Dementia

Image courtesy of Intermountain Medical Center Heart Institute

News | Atrial Fibrillation | May 24, 2018
Atrial fibrillation patients who are diagnosed with carotid artery disease face higher risks for developing dementia,...
Botulinum Toxin (botox) Injection in CABG Patients Reduces AFib After Cardiac Surgery. #HRS2018

Figure 1: At the end of 36 months, the incidence of any atrial tachyarrhythmia was 23.3 percent in the botox group, as compared to 50 percent in the placebo group

News | Atrial Fibrillation | May 18, 2018
Atrial fibrillation ablation using the Abbott Ensite electro mapping system. CABANA Trial Confirms Ablation Equal To or Superior to Drug Therapy. #HRS2018

Atrial fibrillation ablation using the Abbott Ensite electro mapping system.

Feature | Atrial Fibrillation | May 17, 2018
May 16, 2018 – The first results of the randomized, multicenter, long-term, international...
Link Found Between Post-Traumatic Stress, Increased Risk of AFib. #HRS2018
News | Atrial Fibrillation | May 15, 2018
May 15, 2018 — A new study is the first to report a relationship between post-traumatic stress disorder (PTSD) and ne
Marijuana Use Does Not Increase Risk of Arrhythmias, Might Reduce AFib Risk. #HRS2018
News | Atrial Fibrillation | May 15, 2018
May 15, 2018 — According to new research, smoking marijuana may not be associated with an increased risk of ventricul
First Results Reported from AVIATOR 2 Registry for AFib Patients Undergoing PCI.

Photo courtesy of the American Heart Association

News | Atrial Fibrillation | May 15, 2018
May 15, 2018 – Results of the AVIATOR 2 international registry data show a discrepancy between physician perception a
New Combined Risk Score More Effectively Predicts Stroke Risk in AFib Patients

Image courtesy of Intermountain Medical Center Heart Institute

News | Atrial Fibrillation | May 11, 2018
A new study finds that integrating two separate clinical risk score models more accurately helps clinicians assess the...
Depression Linked to Increased Atrial Fibrillation Risk
News | Atrial Fibrillation | March 27, 2018
March 27, 2018 — Depression may increase the risk for...
Overlay Init