BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective therapy for heart failure patients with electromechanical delay. Optimization of atrioventricular interval (AVI) is a cardinal component for the benefits. However, it is unknown if the AVI needs to be re-optimized during long-term follow-up. METHODS: Thirty-one patients (66+/-11 years, 20 males) with sinus rhythm who received CRT underwent serial optimization of AVI at day 1, 3-month and during long-term follow-up by pulse Doppler echocardiography (PDE). At long-term follow-up, the optimal AVI and cardiac output (CO) estimated by non-invasive impedance cardiography (ICG) were compared with those by PDE. RESULTS: The follow-up was 16+/-11 months. There was no significant difference in the mean optimal AVI when compared between any 2 time points among day 1 (99+/-30 ms), 3-month (97+/-28 ms) and long-term follow-up (94+/-28 ms). However, in individual patient, the optimal AVI remained unchanged only in 14 patients (44%), and was shortened in 12 (38%) and lengthened in 6 patients (18%). During long-term follow-up, although the mean optimal AVIs obtained by PDE or ICG (94+/-28 vs. 92+/-29 ms) were not different, a discrepancy was found in 14 patients (45%). For the same AVI, the CO measured by ICG was systematically higher than that by PDE (3.5+/-0.8 Vs. 2.7+/-0.6 L/min, p<0.001). CONCLUSION: Optimization of AVI after CRT appears necessary during follow-up as it was readjusted in 55% of patients. Although AVI optimization by ICG was feasible, further studies are needed to confirm its role in optimizing AVI after CRT.
BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective therapy for heart failurepatients with electromechanical delay. Optimization of atrioventricular interval (AVI) is a cardinal component for the benefits. However, it is unknown if the AVI needs to be re-optimized during long-term follow-up. METHODS: Thirty-one patients (66+/-11 years, 20 males) with sinus rhythm who received CRT underwent serial optimization of AVI at day 1, 3-month and during long-term follow-up by pulse Doppler echocardiography (PDE). At long-term follow-up, the optimal AVI and cardiac output (CO) estimated by non-invasive impedance cardiography (ICG) were compared with those by PDE. RESULTS: The follow-up was 16+/-11 months. There was no significant difference in the mean optimal AVI when compared between any 2 time points among day 1 (99+/-30 ms), 3-month (97+/-28 ms) and long-term follow-up (94+/-28 ms). However, in individual patient, the optimal AVI remained unchanged only in 14 patients (44%), and was shortened in 12 (38%) and lengthened in 6 patients (18%). During long-term follow-up, although the mean optimal AVIs obtained by PDE or ICG (94+/-28 vs. 92+/-29 ms) were not different, a discrepancy was found in 14 patients (45%). For the same AVI, the CO measured by ICG was systematically higher than that by PDE (3.5+/-0.8 Vs. 2.7+/-0.6 L/min, p<0.001). CONCLUSION: Optimization of AVI after CRT appears necessary during follow-up as it was readjusted in 55% of patients. Although AVI optimization by ICG was feasible, further studies are needed to confirm its role in optimizing AVI after CRT.
Authors: Robert G Turcott; Ronald M Witteles; Paul J Wang; Randall H Vagelos; Michael B Fowler; Euan A Ashley Journal: Circ Heart Fail Date: 2010-02-22 Impact factor: 8.790
Authors: Punam A Pabari; Keith Willson; Berthold Stegemann; Irene E van Geldorp; Andreas Kyriacou; Michela Moraldo; Jamil Mayet; Alun D Hughes; Darrel P Francis Journal: Heart Fail Rev Date: 2011-05 Impact factor: 4.214
Authors: Matthew R Ginks; Elena Sciaraffia; Andreas Karlsson; John Gustafsson; Shoaib Hamid; Julian Bostock; Marcus Simon; Carina Blomström-Lundqvist; C Aldo Rinaldi Journal: Europace Date: 2011-04-15 Impact factor: 5.214
Authors: Peter Paul Delnoy; Philippe Ritter; Herbert Naegele; Serafino Orazi; Hanna Szwed; Igor Zupan; Kinga Goscinska-Bis; Frederic Anselme; Maria Martino; Luigi Padeletti Journal: Europace Date: 2013-03-14 Impact factor: 5.214