Overview

It adapts to meet the constantly changing needs of cardiac resynchronization therapy (CRT) patients because it responds to what he or she is doing and automatically decides when and how to pace the heart.

The AdaptivCRT™ algorithm has two different modes:

  • AdaptivCRT™ LV-only pacing occurs during normal AV conduction when the heart rate is less than or equal to 100 beats per minute. It also optimizes A-V timing and minimizes right ventricular (RV) pacing.
  • AdaptivCRT™ BiV pacing occurs during prolonged/blocked AV conduction or when the heart rate is greater than 100 beats per minute. It also optimizes A-V and V-V timing.



Normal AV conduction
and HR ≤ 100 bpm


AdaptivCRT™ LV-only pacing

Prolonged AV conduction
or HR > 100 bpm


AdaptivCRT™ BiV-only pacing



Clinical evidence

Prior studies suggested a benefit in improved response (12%),1 reduced AF (46%),2 and reduced 30-day HF readmissions (59%),3 particularly among patients with normal AV conduction.

AdaptResponse and the AdaptivCRT™ algorithm

Objective

All-cause mortality and intervention for heart failure decompensation showing that the AdaptivCRT™ algorithm is superior to standard CRT (assumed 18% reduction).


Study design4
  • N = 3,617 patients indicated for CRT with left bundle branch block (LBBB), PR ≤ 200 ms
  • 27 countries, 227 centers, 43% women enrolled
  • Prospective, randomized, controlled, multicenter, global trial

Results

AdaptivCRT™ did not show superiority, but did provide similar outcomes to standard CRT, primary endpoint not met.
 

† 3,797 patients recruited between August 2014 and January 2019. 1.6% exited due to unsuccessful implant.


AdaptResponse study

16% mortality is the lowest of any randomized CRT trial.

16% mortality in AdaptResponse at five years is the lowest of any randomized CRT trial, when accounting for NYHA class.4–11

 

‡ Outcomes of total AdaptResponse study cohort.

16%

mortality is the lowest of any randomized CRT trial.


AdaptResponse Study


93% response rate at six months, highest of any CRT trial‡,4,12–19

Highest response rate among CRT trials reporting clinical composite score at six months

 

‡ Outcomes of total AdaptResponse study cohort.

93%

response rate at
six months, highest of
any CRT trial‡,4,12–19



Clinical composite score across CRT trials

High percent Adaptive LV pacing associated with 24% significant reduction in mortality/heart failure events4 (post-hoc analysis)

85% LV pacing was the median in the Adaptive CRT group.

High percentage
Adaptive LV pacing associated with

24%

significant reduction in mortality/heart failure events4 (post-hoc analysis)


AdaptResponse study post-hoc analysis

41% lower rate of device change-outs for battery depletion through eight years with AdaptivCRT™ algorithm4 (post-hoc analysis)

Reduced unnecessary RV pacing with AdaptivCRT™ algorithm increased battery longevity.

41%

lower rate of device change-outs for battery depletion through eight years with AdaptivCRT™ algorithm4 (post-hoc analysis)


AdaptResponse study post-hoc analysis