Fusion-Optimized Intervals (FOI): A New Method to Achieve the Narrowest QRS for Optimization of the AV and VV Intervals in Patients Undergoing Cardiac Resynchronization Therapy.
QRS-Based Optimization of Cardiac Resynchronization Background Optimization of atrioventricular (AV) and interventricular (VV) intervals may improve cardiac resynchronization therapy (CRT) response but is a complex task. Fusion with intrinsic conduction may increase the benefit of CRT. The aim was t...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 25; no. 3; pp. 283 - 293 |
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| Autores principales: | , , , , , , , , , , , , , , |
| Formato: | research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2014
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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=104039029&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104039029 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Mar2014 vid: 25 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104039029 94743622 10.1111/jce.12322 NLM24237881 104039029 ppf: 283 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Fusion-Optimized Intervals (FOI): A New Method to Achieve the Narrowest QRS for Optimization of the AV and VV Intervals in Patients Undergoing Cardiac Resynchronization Therapy. aug: au: Arbelo, Elena Tolosana, JosÉ MarÍA Trucco, Emilce Penela, Diego BorrÀS, Roger Doltra, Adelina Andreu, David AceÑA, Marta Berruezo, Antonio Sitges, Marta Mansour, Fadi Castel, ÁNgeles Matas, Mariona Brugada, Josep Mont, LluÍS affil: Cardiology Department-Thorax Institute-Hospital Clínic, University of Barcelona Institut d' Investigació Biomèdica August Pi i Sunyer (IDIBAPS) sug: subj: Cardiac Resynchronization Therapy QRS Complex Methods Treatment Outcomes Aged Correlation Coefficient Data Analysis Software Descriptive Statistics Female Funding Source Human Interrater Reliability Intraclass Correlation Coefficient Intrarater Reliability Linear Regression Male Middle Age Paired T-Tests Aged: 65+ years Middle Aged: 45-64 years Female Male ab: QRS-Based Optimization of Cardiac Resynchronization Background Optimization of atrioventricular (AV) and interventricular (VV) intervals may improve cardiac resynchronization therapy (CRT) response but is a complex task. Fusion with intrinsic conduction may increase the benefit of CRT. The aim was to describe fusion-optimized intervals (FOI), a new method of optimizing CRT based on QRS duration. Methods and Results Seventy-six consecutive patients with preserved AV conduction who received CRT were prospectively included. The AV interval was optimized by searching the narrowest QRS obtained within the fusion band during left ventricular (LV) pacing. The VV interval was then adjusted, comparing QRS duration in simultaneous biventricular, LV preexcitation (−30 milliseconds), right ventricular (RV) preexcitation (−30 milliseconds) and LV-only pacing. A substudy in 31 patients evaluated the invasive LV +dP/dtmax. The best fusion-optimized AV interval was 136 ± 30 milliseconds during atrial sensing and 192 ± 35 milliseconds during atrial pacing. The best QRS was obtained with simultaneous biventricular pacing in 28 patients (37%), LV preexcitation in 22 (29%), LV-only in 20 (26%), and RV preexcitation in 6 (8%). Baseline QRS was shortened more by FOI (59 ± 19 milliseconds) than by nominal settings (40 ± 21 milliseconds; P < 0.001). Sixty-five patients (86%) showed >10% shortening of the baseline QRS with FOI; none prolonged the QRS duration by FOI compared to nominal settings. All echocardiographic asynchrony parameters were corrected by FOI. Baseline +dP/dtmax improvement was greater in FOI (127 ± 95 mmHg/seconds) than in nominal settings (102 ± 71 mmHg/seconds; P = 0.05). Conclusion The FOI method is feasible, further reduces QRS duration, and improves acute hemodynamic response compared to nominal programming of CRT. pubtype: Academic Journal doctype: research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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