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Biventricular pacing disappoints in BIOPACE trial

Biventricular (BiV) pacing failed to significantly improve outcome compared to right ventricular (RV) pacing in patients with atrio-ventricular block (AVB) according to preliminary results presented  at ESC Congress 2014 today.

Heart Failure (HF)


BARCELONA, Spain – Monday 1 September: Biventricular (BiV) pacing failed to significantly improve outcome compared to right ventricular (RV) pacing in patients with atrio-ventricular block (AVB) according to preliminary results presented as a Hot Line at ESC Congress 2014.
But findings of the BIOPACE (Biventricular pacing for atrIo-ventricular BlOck to Prevent cArdiaC dEsynchronization) trial suggest a non-significant trend in favour of BiV over RV pacing – the latter being the current standard of care.

“Additional analyses will perhaps identify sub-groups for which BiV confers a clear benefit,” suggested principal investigator Jean-Jacques Blanc, MD, from Brest University in Brest, France.


Patients with AVB, a common disease also known as “heart block”, require permanent ventricular pacing because their heart beats too slowly.
RV pacing has been the accepted treatment for AVB, but recent evidence has suggested this approach may have deleterious long-term effects on cardiac structure and function, said Professor Blanc.
The BIOPACE trial, randomised 1810 patients with AVB (mean age 73.5 years) to either RV pacing (n=908) or BiV pacing (n=902) to determine if the latter approach could prevent some of these deleterious effects.
After a mean follow-up of 5.6 years, the groups had a similar rate of the composite endpoint that included time-to-death or first hospitalisation due to heart failure, with a non-significant trend in favour of BiV (hazard ratio [HR] 0.87; p=0.08).
This trend persisted, still without reaching statistical significance, when patients were stratified according to their left ventricular ejection fraction (LVEF). For patients with an LVEF of 50% or less, the HR was 0.92 (p=0.47) and for patients with an LVEF of more than 50% it was 0.88 (p=0.21).  
ENDS

Notes to editor

About the European Society of Cardiology
The European Society of Cardiology (ESC) represents more than 80 000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
About ESC Congress 2014
The ESC Congress is currently the world's largest international congress in cardiovascular medicine.  The spotlight of this year's event is “innovation and the heart”.  ESC Congress 2014 takes place from 30 August to 3 September at the Fira Gran Via in Barcelona, Spain. For more information on ESC Congress 2014 contact the ESC Press Office.
To access all the scientific resources from the sessions during the congress, visit ESC Congress 365
This press release accompanies both a presentation and an ESC press conference at the ESC Congress 2014. Edited by the ESC from material supplied by the investigators themselves, this press release does not necessarily reflect the opinion of the European Society of Cardiology. The content of the press release has been approved by the presenter.
SOURCES OF FUNDING: The study was funded by St. Jude Medical.
DISCLOSURES: Professor Blanc is a consultant for St. Jude Medical.