The Effect of Left Ventricular Electrical Delay on the Acute Hemodynamic Response with Cardiac Resynchronization Therapy.
Effect of QLV on CRT Hemodynamic Response Introduction Cardiac resynchronization therapy (CRT) improves hemodynamic function, as well as reduces hospitalizations and mortality among patients with systolic dysfunction, QRS prolongation, and heart failure. The magnitude of the hemodynamic response is...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 25; no. 6; pp. 624 - 631 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103955136&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103955136 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jun2014 vid: 25 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 103955136 96311635 10.1111/jce.12372 NLM24446891 103955136 ppf: 624 ppct: 7 formats: fmt: @attributes: type: P tig: atl: The Effect of Left Ventricular Electrical Delay on the Acute Hemodynamic Response with Cardiac Resynchronization Therapy. aug: au: Gold, Michael R. Leman, Robert B. Wold, Nicholas Sturdivant, J. Lacy Yu, Yinghong affil: Medical University of South Carolina sug: subj: Cardiac Resynchronization Therapy Hemodynamics Ventricular Dysfunction, Left Heart Failure Therapy Defibrillators, Implantable Utilization Funding Source Predictive Value of Tests Human Middle Age Aged Male Female Post Hoc Analysis Descriptive Statistics Data Analysis Software Two-Way Analysis of Variance Electrocardiography Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Effect of QLV on CRT Hemodynamic Response Introduction Cardiac resynchronization therapy (CRT) improves hemodynamic function, as well as reduces hospitalizations and mortality among patients with systolic dysfunction, QRS prolongation, and heart failure. The magnitude of the hemodynamic response is associated with improved outcomes, so optimization of this parameter is a goal of therapy. The purpose of this study was to evaluate the effect of left ventricular (LV) electrical delay, as assessed by the QLV interval, on the acute hemodynamic response to CRT. Methods and Results This study included 31 patients undergoing biventricular ICD placement. At implant, invasive LV dP/dt was measured by a micromanometer catheter during biventricular (BV) or LV only pacing. Both atrial sensing (AS) and atrial pacing (AP) modes were evaluated at 5 different AV delays, tested in randomized order. The QLV interval was measured at the LV pacing site. Compared with intrinsic rhythm, CRT increased LV dP/dtmax by 9.5 ± 8.8% with BV pacing and 10.0 ± 9.2% with LV pacing (P = 0.38) during AS. With AP, CRT increased LV dP/dtmax by 16.0 ± 10.8% and 15.3 ± 11.1%, respectively (P = 0.47). QLV was strongly correlated with the hemodynamic response in all pacing configurations. Multivariate analysis showed that with BV pacing QLV was an independent predictor of the hemodynamic response with a 1.7% increase in %LV dP/dt for every 10 milliseconds prolongation of QLV. Conclusions LV electrical delay is a strong predictor of the acute hemodynamic response to CRT. This relationship is independent of pacing mode. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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