A Fast and Simple Echocardiographic Method of Determination of the Optimal Atrioventricular Delay in Patients After Biventricular Stimulation

Meluzı́n, Jaroslav; Novák, Miroslav; Müllerová, Jolana; Krejčí, Jan; Hude, Petr; Eisenberger, Martin; Dušek, Ladislav; Dvořák, I; Špinarová, Lenka

doi:10.1111/j.1540-8159.2004.00386.x

Cited by 83 publications

(46 citation statements)

References 20 publications

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“…One of the most important parameters to guide AV delay optimization is the level of true biventricular pacing or, vice versa, the degree of QRS fusion as a result of intrinsically conducted ventricular excitation [19][20][21]. In our cohort, 45.3% of patients presented with an AV delay too long to avoid any QRS fusion.…”

Section: Av Delay Optimization and Qrs Fusionmentioning

confidence: 92%

Comprehensive cardiac resynchronization therapy optimization in the real world

et al. 2014

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Background: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients suffering from chronic heart failure (CHF (17.5% and 28.4% for sAV and pAV, respectively). In contrast, interventricular delay (VV delay) was rarely changed (11.9%). Conclusions: In our "real world" cohort, a substantial proportion of patients presented to their first post-operative consultation with suboptimal device settings. Our data indicate that the opportunity to optimize device settings is frequently wasted in the "real world", underlining the necessity for expert device follow-up to deliver optimal care to this challenging group of heart failure patients. (Cardiol J 2014; 21, 3: 316-324)

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Section: Av Delay Optimization and Qrs Fusionmentioning

confidence: 92%

Comprehensive cardiac resynchronization therapy optimization in the real world

et al. 2014

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“…AV delay was optimized in patients with sinus rhythm, using our developed and published method 12 . Responders to CRT were defined by the improvement in NYHA class.…”

Section: Methodsmentioning

confidence: 99%

Usefulness of Left Ventricle Dyssynchrony Assessment Before Cardiac Resynchronization Implantation

Lipoldová¹,

Ozábalová²,

Meluzı́n³

et al. 2010

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background.A number of trials have demonstrated the effect of cardiac resynchronization therapy (CRT) on functional improvement and reversed left ventricle remodeling. Meeting contemporary guidelines approximately 30-40% of patients do not respond to CRT (non-responders).Aim. To quantify the predictive ability of basal QRS width and basal echocardiographic parameters of left ventricle contraction dyssynchrony in our group of CRT patients. To compare effectiveness of these parameters assessment in patients with ischemic (iCMP) and non-ischemic cardiomyopathy (niCMP) and with sinus rhythm (SR) and atrial fibrillation (AF).Patients and methods. 194 patients after successful introduction of CRT device were evaluated. Evaluation of NYHA function class, QRS width and echocardiographic parameters including parameters of left ventricle contraction dyssynchrony (SPWMD: septal-to-posterior wall motion delay, Ts-sep-lat: time interval between maximum of systolic movement of septum and lateral wall using tissue Doppler imaging, IVMD: interventricular mechanical delay) performed before implantation and 3 months after implantation of CRT device.Results. Responder (improved in NYHA class after CRT) rate was 61%. SR patients showed higher benefit compared to AF patients (responder rate 63% vs. 52%, p<0.05). Narrowing of QRS width after CRT was observed only in responders. SPWMD and Ts-sep-lat decreased after CRT in all subgroups. SPWMD dyssynchrony (SPMWD ≥ 130 ms) reduction after CRT was more expressed in niCMP population. Ts-sep-lat dyssynchrony (Ts-sep-lat ≥ 65 ms) reduction after CRT was more expressed in SR patients. IVMD (IVMD ≥ 60 ms) remained unchanged in average, but significant decrease was observed in responders and significant increase in non-responders. QRS width, SPWMD and Ts-sep-lat showed moderate sensitivity but poor specificity to predict CRT benefit. QRS width ≥ 150 ms in niCMP patients showed higher sensitivity to predict CRT effect compared to iCMP patients (91%, 65% respectively). IVMD showed poor sensitivity but good specificity to predict CRT benefit. IVMD in SR patients (compared to AF patients) showed higher specificity to predict CRT effect (90%, 63% respectively).Conclusion. None of tested left ventricle contraction dyssynchrony parameters showed good sensitivity and specificity to predict CRT benefit. QRS width as a predictor factor was more beneficial in non-ischemic patients and IVMD in sinus rhythm patients.

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“…Dies wird insbesondere im Rahmen der individuellen AV-Zeit-Optimierung genutzt, wobei eine möglichst lange Füllungszeit ohne Verkür-zung der A-Welle als Ausdruck einer zu frühen Ventrikelkontraktion (sog. atriale Pfropfung) angestrebt wird [27,35].…”

Section: Zusammenfassungunclassified

Echokardiographie bei kardialer Resynchronisationstherapie

Göbel¹,

Becker²,

Franke³

et al. 2005

Schweiz Ärzteztg

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Summary Echocardiogaphy in cardiac resynchronisation therapyAn uncoordinated contraction process in patients with cardiac failure is a contributory factor in restricting haemodynamic function independently of myocardial damage at cell level. Cardiac resynchronisation therapy, usually in the form of biventricular stimulation, has brought considerable progress in the treatment of this patient population in the last few years. One difficulty that remains, however, is the selection of suitable patients. In addition to the ECG criteria of asynchronism (QRS broadening over 130-150 ms), echocardiography offers a variety of complementary approaches to quantification of the asynchronism. These are discussed here.

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A Fast and Simple Echocardiographic Method of Determination of the Optimal Atrioventricular Delay in Patients After Biventricular Stimulation

Cited by 83 publications

References 20 publications

Comprehensive cardiac resynchronization therapy optimization in the real world

Comprehensive cardiac resynchronization therapy optimization in the real world

Usefulness of Left Ventricle Dyssynchrony Assessment Before Cardiac Resynchronization Implantation

Echokardiographie bei kardialer Resynchronisationstherapie

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