Whether noninvasive optimization of AV and VV delays improves the response to cardiac resynchronization therapy

Urbanek, Bożena; Chudzik, Michał; Klimczak, Artur; Rosiak, Marcin; Lewek, Joanna; Wranicz, Jerzy Krzysztof

doi:10.5603/cj.2013.0100

Cited by 5 publications

(2 citation statements)

References 31 publications

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“…25) Combining optimized AVDs/ VVDs provided the best hemodynamic response. 26) Problems of AVD/VVD optimization with UCG: Choosing a method for AVD/VVD optimization is a crucial matter. UCG is the most widely used method; however, one study demonstrated that the optimization of AVD and IMPEDANCE CARDIOGRAPHY FOR CRT OPTIMIZATION VVD with UCG failed to significantly improve SV.…”

Section: 54)mentioning

confidence: 99%

The Usefulness and Limitations of Impedance Cardiography for Cardiac Resynchronization Therapy Device Optimization

et al. 2020

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Identifying the optimal atrioventricular (AV) or interventricular (VV) delay is beneficial for patients using cardiac resynchronization therapy (CRT) devices. Ultrasonic echocardiography (UCG) has been the most commonly used method; however, it requires high technical knowledge. Impedance cardiography (ICG) can calculate stroke volume by measuring changes in transthoracic electric impedance. This study sought to assess the clinical utility of ICG in comparison with that of UCG for the optimization of CRT devices. Patients who underwent CRT device implantation were retrospectively analyzed. One week after implantation, optimization of AV delay (AVD) was performed in every patient with ICG (AVD-ICG) and UCG (AVD-UCG). VV delay (VVD) was then determined according to the optimal AVD using these two methods. Forty-two patients were enrolled. Average AVD-ICG was significantly shorter than AVD-UCG (128 ± 49 versus 146 ± 41 milliseconds, P = 0.018). Five patients (12%) had the same optimized AVD with two methods, and the difference between AVD-ICG and AVD-UCG was !20 milliseconds in 19 patients (45%). In the multivariate analysis, the presence of postoperative mitral regurgitation (MR) was an independent predictor of AVD-ICG/AVD-UCG mismatch, defined as a difference over 20 milliseconds (odds ratio = 10.71; 95% confidence interval = 1.72 to 66.72; P = 0.018). The results of optimized VVD were similar using both methods. ICG might be a promising tool for the rapid optimization of CRT devices. However, in patients with moderate-to-severe MR, ICG may not be able to optimize AVD.

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Section: 54)mentioning

confidence: 99%

The Usefulness and Limitations of Impedance Cardiography for Cardiac Resynchronization Therapy Device Optimization

et al. 2020

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“…Unlike in recent years, optimization of the therapy is performed a few weeks after implantation, using simple echocardiographic measurements, since the atrioventricular and interventricular intervals may be different in each individual and change over time. Several studies [55][56][57] show improved cardiac failure data and even improved survival in patients with scheduled post-implant visits. At these visits, problems can be detected with early correction and improvement of the prognosis of these patients (malignant ventricular arrhythmias, atrial fibrillation, ventricular pacing time of less than 90-95%, diaphragmatic pacing, inadequate electrode pacing, etc.).…”

Section: Optimization Of Resynchronization Therapymentioning

confidence: 99%

Cardiac Resynchronization Therapy in Advanced Heart Failure: Predictors of Response and Optimization of Therapy

Ángel¹,

Alfonso²,

Ángeles³

2017

The Role of the Clinical Cardiac Electrophysiologist in the Management of Congestive Heart Failure

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Heart failure affects a high percentage of the population, especially older patients. Cardiac resynchronization therapy is indicated in some patients with advanced heart failure. However, 20-40% of patients with implanted resynchronization device have no clinical response. In this chapter, we review factors related with the absence of a clinical response, recent technological advances that can reduce the failure rate, and an algorithm for management of patients without a clinical response.

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Delay optimization of multipoint pacing increases the cardiac index and narrows the QRS width

Zhang

Liu

Deng

et al. 2020

Journal of Electrocardiology

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Whether noninvasive optimization of AV and VV delays improves the response to cardiac resynchronization therapy

Abstract: (Cardiol J 2013; 20, 4: 411-417)

Cited by 5 publications

References 31 publications

The Usefulness and Limitations of Impedance Cardiography for Cardiac Resynchronization Therapy Device Optimization

The Usefulness and Limitations of Impedance Cardiography for Cardiac Resynchronization Therapy Device Optimization

Cardiac Resynchronization Therapy in Advanced Heart Failure: Predictors of Response and Optimization of Therapy

Delay optimization of multipoint pacing increases the cardiac index and narrows the QRS width

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