A Growing Body of Evidence for Multipoint™ Pacing (MPP)

The U.S. IDE Study

Meeting Safety and Efficacy Endpoints¹

The recent MPP U.S. IDE study from Tomassoni et al. showed:

• Safety: 93.2% freedom from system-related complications¹
• Efficacy: MPP technology demonstrated to be noninferior to BiV with respect to non-responder rate¹

Converting Non-Responders to Responders¹

The sub-analysis study demonstrated that wider cathode spacing and near-simultaneous intraventricular timing delays are best. When MPP technology was programmed with cathode spacing ≥ 30 mm and 5 ms LV delay:

• CRT response rate was greatest at 87% and the super-responder rate was greatest at 54% (n = 52)¹
• Non-responders were converted to responders (8 of 8 patients)¹

Conclusions from the U.S. IDE study include:

• MPP technology is safe and effective¹
• The enrolled patient population had a high response rate to quadripolar BiV pacing¹
• MPP technology response rates for this patient population are greatest when devices are programmed with wide LV electrode spacing and short intraventricular delay¹
• There is a growing body of evidence that MPP is a feature that physicians can use to potentially improve responder rates¹

Multipoint Pacing Data from International Studies

Several international studies report results related to improved patient response to CRT with MPP as compared to single-site pacing.
 

Reported Improvements of CRT Response Rate At 12 Months²

Zanon et al. compared 20 patients optimized with MPP to 36 patients optimized with traditional BiV pacing and 54 nonoptimized BiV patients.² The results indicate a progression in response from nonoptimized BiV to optimized BiV to optimized with MPP at 12 months consistently measured over three definitions of response:

• 90% response rate with MPP measured by ESV decrease > 15%²
• 95% response rate with MPP measured by ≥ 1 decrease in NYHA class²
• 90% response rate with MPP measured by Packer’s score²

ΔESVi, ΔNYHA, and PACKER’S response rates. Response indicates ΔESVi ≥ 15%, ΔNYHA Class > 0, or PACKER’S score = 0 at follow-up relative to baseline. The vertical segments represent the 95% CI of the estimated proportions.

Reported Improvements in Ejection Fraction at 6 Months³

Forleo et al. compared the changes in ejection fraction (EF) in 232 patients with a 6-month follow-up.³ During implant, capture thresholds were measured as well as the presence of PNS. The results show:

• MPP technology was programmable in 97% of patients³
• An improvement in clinical composite score in a greater proportion of patients with MPP-ON (56% vs. 38%; P=0.009)³
• Ejection Fraction was significantly higher in the MPP group than in the biventricular-pacing group (39.1%+-9.6% vs. 34.7%+-7.6%; P<0.001)³

In summary, the Italian MPP technology registry (IRON-MPP) study showed QRS was reduced and both EF and clinical composite score improved with MPP technology relative to conventional BiV.³

Building Comprehensive Heart Failure Management

The Quadra Allure MP CRT-P is one of our heart failure management therapies. Our vision is to transform the treatment of heart failure by designing technology that delivers excellent clinical outcomes and improves workflow and efficiency. Read more about our approach to heart failure management.