Contractibility sensor signal evolution predicts cardiovascular events in patients with cardiac resynchronization therapy

Background. - While a multicentre trial has demonstrated that the SonR (TM) contractibility sensor is as effective as echocardiography-guided optimization at improving response to cardiac therapy; resynchronization an association between SonR (TM) values and clinical endpoints has not been established. Aims. - The primary objective was to assess the predictive value of SonR (TM) signal evolution regarding cardiovascular events in patients implanted with a cardiac resynchronization therapy Ventricular device. The secondary objective was to evaluate whether SonR (TM) signal evolution was associated with cardiovascular death. Methods. - All patients with a SonR (TM) system implanted between 2012 and 2016 were included in this retrospective study. SonR (TM) signal evolution was calculated over the first 6 months after implantation: ([month 6 value - month 1 value]/month 1 value)*100. The primary endpoint (cardiovascular events) was a composite of cardiovascular death, hospitalization for acute heart failure or ventricular arrhythmia. Results. - Seventy-four patients (median age 67 years; 81% men) were followed up over a median 20 (13; 29) months. Cumulative incidence function showed that SonR (TM) signal evolution was predictive of cardiovascular events (threshold < 10.70%; P=0.023) and predictive of cardiovascular death (P= 0.0018). After multivariable analysis, SonR (TM) signal evolution was independently associated with the onset of cardiovascular events (hazard ratio: 4.03, 95% confidence interval: 1.31-12.43; P= 0.015), even after adjustment for left bundle branch block and chronic kidney disease. Conclusions. - In this first study publishing data on SonR (TM) signals in a real-life setting, SonR (TM) signal evolution over the first 6 months after cardiac resynchronization implantation was an independent predictor of cardiovascular events at follow-up. This variable could be useful to identify patients at higher risk of further adverse events after cardiac resynchronization implantation. (C)2018 Elsevier Masson SAS. All rights reserved.