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- Title
Cardiac Resynchronization Therapy: Variations in Echo-Guided Optimized Atrioventricular and Interventricular Delays During Follow-Up.
- Authors
Valzania, Cinzia; Biffi, Mauro; Martignani, Cristian; Diemberger, Igor; Bertini, Matteo; Ziacchi, Matteo; Bacchi, Letizia; Rocchi, Guido; Rapezzi, Claudio; Branzi, Angelo; Boriani, Giuseppe
- Abstract
Background: Relatively few data are available on long-term echocardiographic optimization of atrioventricular (AV) and interventricular (VV) delay programming in cardiac resynchronization therapy (CRT). We assessed variations in optimized AV and VV delays during long-term follow-up. Methods: Thirty-seven consecutive heart failure patients received Doppler echocardiographic optimization of AV and VV delay within 48 hours from CRT device implantation, at 6 months and at 12 months (the last for the first enrolled 14 patients). Results: After implantation, median optimized AV delay was 100 ms (range, 45 ms); VV optimization led to simultaneous biventricular activation in 4 patients, left ventricular preactivation in 17 patients and right ventricular preactivation in 16 patients. At 12 months median AV delay decreased to 85 ms (23 ms) (P < 0.05 vs. baseline). With respect to previous assessment, VV delay variations ≥40 ms were observed in 41% of the patients at 6 months and in 57% of the tested patients at 12 months. A nonconcordance (by Kappa test) of optimized VV delays was found between each new assessment and the previous one. VV delay optimization was associated with significant (P < 0.001) increases in aortic velocity time integral both at baseline and during follow-up. Conclusions: Echocardiographic optimization of AV and VV delay is associated with broad intraindividual variability during follow-up. A new assessment of optimized VV delays during long-term follow-up reveals a nonconcordance with previous values and provides increases in forward stroke volume.
- Subjects
IMAGING systems; CORONARY disease; DOPPLER ultrasonography; DOPPLER echocardiography; CARDIAC pacing; ARRHYTHMIA treatment
- Publication
Echocardiography, 2007, Vol 24, Issue 9, p933
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/j.1540-8175.2007.00491.x