AIM: Atrioventricular (AV) delay optimization improves hemodynamics and clinical parameters in patients treated with cardiac resynchronization therapy and dual-chamber-pacemakers (PM). However, data on optimizing AV delay in patients treated with VDD-PMs are scarce. We, therefore, investigated the acute and chronic effects of AV delay optimization on hemodynamics in patients treated with VDD-PMs due to AV-conduction disturbances. METHODS: In this prospective, single-center interventional trial, we included 64 patients (38 men, 26 women, median age: 77 (70-82) years) with implanted VDD-PM. AV-delay optimization was performed using a formula based on the surface electrocardiogram (ECG). Hemodynamic parameters (stroke volume (SV), cardiac output (CO), heart rate (HR), and blood pressure (BP)) were measured at baseline and follow-up after 3 months using impedance cardiography. RESULTS: Using an ECG formula for AV-delay optimization, the AV interval was decreased from 180 (180-180) to 75 (75-100) ms. At baseline, AV-delay optimization led to a significant increase of both SV (71.3 ± 15.8 vs. 55.3 ± 12.7 ml, p < 0.001, for optimized AV delay vs. nominal AV interval, respectively) and CO (5.1 ± 1.4 vs. 3.9 ± 1.0 l/min, p < 0.001), while HR and BP remained unchanged. At follow-up, the improvement in CO remained stable (4.9 ± 1.3 l/min, p = 0.09), while SV slightly, but significantly, decreased (to 65.1 ± 17.6, p < 0.01). CONCLUSION: AV-delay optimization in patients treated with VDD-PMs exhibits immediate beneficial effects on hemodynamic parameters that are sustained for 3 months.
AIM: Atrioventricular (AV) delay optimization improves hemodynamics and clinical parameters in patients treated with cardiac resynchronization therapy and dual-chamber-pacemakers (PM). However, data on optimizing AV delay in patients treated with VDD-PMs are scarce. We, therefore, investigated the acute and chronic effects of AV delay optimization on hemodynamics in patients treated with VDD-PMs due to AV-conduction disturbances. METHODS: In this prospective, single-center interventional trial, we included 64 patients (38 men, 26 women, median age: 77 (70-82) years) with implanted VDD-PM. AV-delay optimization was performed using a formula based on the surface electrocardiogram (ECG). Hemodynamic parameters (stroke volume (SV), cardiac output (CO), heart rate (HR), and blood pressure (BP)) were measured at baseline and follow-up after 3 months using impedance cardiography. RESULTS: Using an ECG formula for AV-delay optimization, the AV interval was decreased from 180 (180-180) to 75 (75-100) ms. At baseline, AV-delay optimization led to a significant increase of both SV (71.3 ± 15.8 vs. 55.3 ± 12.7 ml, p < 0.001, for optimized AV delay vs. nominal AV interval, respectively) and CO (5.1 ± 1.4 vs. 3.9 ± 1.0 l/min, p < 0.001), while HR and BP remained unchanged. At follow-up, the improvement in CO remained stable (4.9 ± 1.3 l/min, p = 0.09), while SV slightly, but significantly, decreased (to 65.1 ± 17.6, p < 0.01). CONCLUSION: AV-delay optimization in patients treated with VDD-PMs exhibits immediate beneficial effects on hemodynamic parameters that are sustained for 3 months.
Authors: Stefan E Hardt; Said Hashem Fani Yazdi; Alexander Bauer; Arthur Filusch; Grigorios Korosoglou; Alexander Hansen; Raffi Bekeredjian; Philipp Ehlermann; Andrew Remppis; Hugo A Katus; Helmut F Kuecherer Journal: Int J Cardiol Date: 2006-08-07 Impact factor: 4.164
Authors: Martin U Braun; Andreas Schnabel; Thomas Rauwolf; Matthias Schulze; Ruth H Strasser Journal: J Interv Card Electrophysiol Date: 2005-09 Impact factor: 1.900
Authors: Navinder S Sawhney; Alan D Waggoner; Sanjeev Garhwal; Mohit K Chawla; Judy Osborn; Mitchell N Faddis Journal: Heart Rhythm Date: 2004-11 Impact factor: 6.343
Authors: Bernhard Strohmer; Max Pichler; Martin Froemmel; Mario Migschitz; Florian Hintringer Journal: Pacing Clin Electrophysiol Date: 2004-04 Impact factor: 1.976
Authors: Konstantin M Heinroth; Marcel Elster; Sebastian Nuding; Frithjof Schlegel; Arnd Christoph; Justin Carter; Michael Buerke; Karl Werdan Journal: Europace Date: 2007-05-11 Impact factor: 5.214