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- Title
The Optimized V-V Interval Determined by Interventricular Conduction Times Versus Invasive Measurement by LVdP/dt<sub>MAX</sub>.
- Authors
VAN GELDER, BERRY M.; MEIJER, ALBERT; BRACKE, FRANK A.
- Abstract
Introduction: We compared the calculated optimal V-V interval derived from intracardiac electrograms (IEGM) with the optimized V-V interval determined by invasive measurement of LVdP/dtMAX. Methods and Results: Thirty-two patients with heart failure (six females, ages 68 ± 7.8 years) had a CRT device implanted. After implantation of the atrial, right and a left ventricular lead, the optimal V-V interval was calculated using the QuickOpt™ formula (St. Jude Medical, Sylmar, CA, USA) applied to the respective IEGM recordings (V-VIEGM), and also determined by invasive measurement of LVdP/dtMAX (V-VdP/dt). The optimal V-VIEGM and V-VdP/dt intervals were 52.7 ± 18 ms and 24.0 ± 33 ms, respectively (P = 0.017), without correlation between the two. The baseline LVdP/dtMAX was 748 ± 191 mmHg/s. The mean value of LVdP/dtMAX at invasive optimization was 947 ± 198 mmHg/s, and at the calculated optimal V-VIEGM interval 920 ± 191 mmHg/s (P < 0.0001). In spite of this significant difference, there was a good correlation between both methods (R = 0.991, P < 0.0001). However, a similarly good correlation existed between the maximum value of LVdP/dtMAX and LVdP/dtMAX at a fixed V-V interval of 0 ms (R = 0.993, P < 0.0001), or LVdP/dtMAX at a randomly selected V-V interval between 0 and +80 ms (R = 0.991, P < 0.0001). Conclusion: Optimizing the V-V interval with the IEGM method does not yield better hemodynamic results than simultaneous BiV pacing. Although a good correlation between LVdP/dtMAX determined with V-VIEGM and V-VdP/dt can be constructed, there is no correlation with the optimal settings of V-V interval in the individual patient.
- Subjects
HEART diseases; THERAPEUTICS; ECHOCARDIOGRAPHY; CARDIAC output; HEMODYNAMICS; HEART beat
- Publication
Journal of Cardiovascular Electrophysiology, 2008, Vol 19, Issue 9, p939
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/j.1540-8167.2008.01160.x