Acute evaluation of programmer-guided AV/PV and VV delay optimization comparing an IEGM method and echocardiogram for cardiac resynchronization therapy in heart failure patients and dual-chamber ICD implants.

Introduction: Intracardiac delay optimization of biventricular and dual-chamber pacing devices currently relies on time-consuming echocardiographic measurements. A novel intracardiac electrogram (IEGM) method for atrioventricular (AV/PV) and interventricular (VV) delay optimization was developed, wh...

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Published in:Journal of Cardiovascular Electrophysiology Vol. 18; no. 2; pp. 185 - 192
Main Authors: Baker JH II, McKenzie J III, Beau S, Greer GS, Porterfield J, Fedor M, Greenberg S, Daoud EG, Corbisiero R, Bailey JR, Porterfield L
Format: clinical trial research tables/charts Journal Article
Published: Wiley-Blackwell Feb2007
Online Access:View this record in EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Acute evaluation of programmer-guided AV/PV and VV delay optimization comparing an IEGM method and echocardiogram for cardiac resynchronization therapy in heart failure patients and dual-chamber ICD implants.
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        au:
          Baker JH II
          McKenzie J III
          Beau S
          Greer GS
          Porterfield J
          Fedor M
          Greenberg S
          Daoud EG
          Corbisiero R
          Bailey JR
          Porterfield L
        affil: St. Thomas Hospital, Nashville, Tennessee
      sug:
        subj:
          Cardiac Output, Decreased Therapy
          Cardiac Output, Decreased Ultrasonography
          Defibrillators, Implantable
          Echocardiography Methods
          Outcomes (Health Care) Methods
          Pacemaker, Artificial Methods
          Cardiac Resynchronization Therapy
          Aged
          Clinical Trials
          Comparative Studies
          Electrocardiography
          Female
          Funding Source
          Male
          Middle Age
          Multicenter Studies
          Treatment Outcomes
          Human
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Introduction: Intracardiac delay optimization of biventricular and dual-chamber pacing devices currently relies on time-consuming echocardiographic measurements. A novel intracardiac electrogram (IEGM) method for atrioventricular (AV/PV) and interventricular (VV) delay optimization was developed, which can be performed during routine device follow-up. Methods and Results: In this prospective, nonrandomized, multi-center trial, patients previously implanted with St. Jude Medical cardiac resynchronization therapy defibrillator (CRT-D) devices or dual-chamber implantable cardioverter defibrillators (ICDs) underwent standard AV/PV and/or VV delay optimization guided by Doppler echocardiogram measurements of the maximum aortic velocity time integral (aortic VTI). Aortic VTI measurements applying the IEGM method recommended delays were then obtained in all patients. Fifty-eight patients (age: 68 ± 11 years; 81% male; 74% ischemic) and 57 patients (age: 71 ± 10 years; 74% male; 71% ischemic) were enrolled for AV/PV and VV delay evaluation, respectively. An independent core lab determined the maximum aortic VTIs. Data analysis of the AV, PV, and VV delays demonstrated the concordance correlation coefficient (CCC) between the standard method aortic VTI values and the IEGM method aortic VTI values was 97.5%, 96.1%, and 96.6%, respectively. All analyses demonstrated that the CCC > 90% (P < 0.05). Conclusion: The automated programmer-based IEGM method provides a reliable and simpler alternative to standard techniques for the optimization of AV/PV and VV delay settings in patients with CRT-D devices and dual-chamber ICDs.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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