Combination of the best pacing configuration and atrioventricular and interventricular delays optimization in cardiac resynchronization therapy.
Abstract: Background: Cardiac resynchronization therapy optimization can be pursued by left ventricular pacing vector selection and atrioventricular (AV) and interventricular (VV) delays optimization. The combination of these methods and its comparison with multipoint pacing (MPP) is scarcely studie...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 41; no. 4; pp. 362 - 368 |
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| Autores principales: | , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2018
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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=129103152&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129103152 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Apr2018 vid: 41 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 129103152 129103152 129103152 10.1111/pace.13294 129103152 ppf: 362 ppct: 6 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Combination of the best pacing configuration and atrioventricular and interventricular delays optimization in cardiac resynchronization therapy. aug: au: Socie, Pierre Squara, Fabien Semichon, Marc Thomas, Olivier Khemache, Alain Riccini, Philippe Squara, Pierre Algalarrondo, Vincent Moubarak, Ghassan affil: Department of Electrophysiology and Pacing, Centre Médico‐Chirurgical Ambroise Paré, Neuilly‐sur‐Seine, France sug: subj: Cardiac Resynchronization Therapy Methods Cardiac Pacing, Artificial Methods Heart Diseases Therapy Atrioventricular Node Human Descriptive Statistics Male Female Aged, 80 and Over Aged P-Value Heart Ventricle, Left Cardiac Output Electrodes Heart Conduction System Aged, 80 & over Aged: 65+ years Male Female ab: Abstract: Background: Cardiac resynchronization therapy optimization can be pursued by left ventricular pacing vector selection and atrioventricular (AV) and interventricular (VV) delays optimization. The combination of these methods and its comparison with multipoint pacing (MPP) is scarcely studied. Methods: Using noninvasive cardiac output (CO) measurement, the best of five left ventricular pacing vectors was determined, then AV and VV delays optimization was applied on top of the best vector. Response to the optimization protocol was defined as a >5% CO increase compared to the standard biventricular configuration. Results: Twenty‐two patients (18 men, age 71 ± 9 years) were included. Standard biventricular configuration increased CO compared to baseline (4.65 ± 1.55 L/min vs 4.27 ± 1.53 L/min, respectively, P = 0.02). The best quadripolar configuration increased CO to 4.85 ± 1.67 L/min (P = 0.03 compared to the standard biventricular configuration). AV then VV delay optimization both provided additional benefit (final CO 5.56 ± 2.03 L/min, P = 0.001 compared to the best quadripolar configuration). Fifteen (68%) patients responded to the optimization protocol. Anatomical MPP (based on maximal anatomical separation between electrodes) and electrical MPP (based on maximal electrical activation difference between electrodes) were evaluated in 16 patients and yielded a CO similar to that of the optimization procedure. Conclusions: The combination of choosing the best quadripolar pacing configuration and optimizing atrioventricular and interventricular delays resulted in an improvement of cardiac output compared to standard biventricular stimulation in 68% of patients. The final cardiac output was comparable to multipoint pacing. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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