State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, DongDan SanTiao 9, DongCheng District, Beijing, People's Republic of China.
Heart Fail Rev. 2018 Nov;23(6):927-934. doi: 10.1007/s10741-018-9737-5.
Cardiac resynchronization therapy (CRT) is an effective treatment for selected patients with systolic heart failure. Unlike conventional biventricular pacing (BIP), the left ventricular multipoint pacing (MPP) can increase the number of left ventricular pacing sites via a quadripolar lead positioned in the coronary sinus. This synthetic study was conducted to integratively and quantitatively evaluate the clinical outcome of MPP in comparison with BIP. We systematically searched the databases of EMBASE, Ovid medline, and Cochrane Library through May 2018 for studies comparing the clinical outcome of MPP with BIP in the patients who accepted CRT. Hospitalization for reason of heart failure, left ventricular eject fraction (LVEF), CRT response, all-cause morbidity, and cardiovascular death rate was collected for meta-analysis. A total of 11 studies with 29,606 participants were included in this meta-analysis. Compared with BIP group, MPP decreased heart failure hospitalization (OR, 0.41; 95% CI, 0.33 to 0.50; P < 0.00001), improved LVEF (mean difference, 4.97; 95% CI, 3.11 to 6.83; P < 0.00001), increased CRT response (OR, 3.64; 95% CI, 1.68 to 7.87; P = 0.001), and decreased all-cause morbidity (OR, 0.41; 95% CI, 0.26-0.66; P = 0.0002) and cardiovascular death rate (OR, 0.21; 95% CI, 0.11-0.40; P < 0.00001). The published literature demonstrates that MPP was more effective than BIP in the heart failure patients who accepted cardiac resynchronization therapy.
心脏再同步治疗（CRT）是一种治疗收缩性心力衰竭患者的有效方法。与传统的双心室起搏（BIP）不同，通过在冠状窦中放置四极导线，可以增加左心室多点起搏（MPP）的左心室起搏部位数量。本综合研究旨在综合定量评估 MPP 与 BIP 相比的临床效果。我们通过 EMBASE、Ovid medline 和 Cochrane Library 数据库系统检索了截至 2018 年 5 月比较 CRT 患者 MPP 与 BIP 临床疗效的研究。收集心力衰竭住院、左心室射血分数（LVEF）、CRT 反应、全因发病率和心血管死亡率进行荟萃分析。共有 11 项研究纳入了 29606 名患者。与 BIP 组相比，MPP 降低心力衰竭住院率（OR，0.41；95%CI，0.33 至 0.50；P<0.00001）、改善 LVEF（均数差，4.97；95%CI，3.11 至 6.83；P<0.00001）、提高 CRT 反应率（OR，3.64；95%CI，1.68 至 7.87；P=0.001）、降低全因发病率（OR，0.41；95%CI，0.26 至 0.66；P=0.0002）和心血管死亡率（OR，0.21；95%CI，0.11 至 0.40；P<0.00001）。已发表的文献表明，MPP 在接受心脏再同步治疗的心力衰竭患者中比 BIP 更有效。
