Gain in Real-World Cardiac Resynchronization Therapy Efficacy with SyncAV Dynamic Optimization: Heart Failure Hospitalizations and Costs.

Abstract Background SyncAV™, a device-based cardiac resynchronization therapy (CRT) algorithm, promotes electrical optimization by dynamically adjusting atrioventricular intervals. Objective Evaluate impact of SyncAV™ on heart failure hospitalizations (HFH) and related costs in a real-world CRT cohort. Methods Subjects with SyncAV™-capable CRT devices followed by remote monitoring and enrolled in Medicare fee-for-service (M-FFS) for at least 1 year before and up to 2 years post-implant were studied. Patients with SyncAV™ON were 1:4 matched to SyncAV™OFF using pre-implant HFH rate, demographics, comorbidities, disease etiology, and left bundle branch block. HFH was determined from primary diagnosis of inpatient hospitalizations, and the cost for each event from the sum of Medicare, supplemental insurance, and patient payment. Results After 1:4 matching, 3,630 subjects were included (age 75±8 years, 38% female), with 726 patients with SyncAV™. Pre-CRT HFH rate was 0.338 HFH/patient-year. CRT diminished HFH rate to 0.204 per patient-year (p Conclusion This large, real-world, propensity-matched study demonstrates that SyncAV™ CRT is associated with significantly reduced heart failure hospitalizations and associated costs, incremental to standard CRT.