An electrographic AV optimization for the maximum integrative atrioventricular and ventricular resynchronization in CRT.
Background: Atrioventricular (AV) delay could affect AV and ventricular synchrony in cardiac resynchronization therapy (CRT). Strategies to optimize AV delay according to optimal AV synchrony (AVopt-AV) or ventricular synchrony (AVopt-V) would potentially be discordant. This study aimed to explore a...
| Publicado en: | BMC Cardiovascular Disorders Vol. 21; no. 1; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts tracings Journal Article |
| Publicado: |
BioMed Central
6/10/2021
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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=150821260&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 150821260 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712261 1CHA jtl: BMC Cardiovascular Disorders issn: 14712261 maglogo: N pubinfo: dt: 6/10/2021 vid: 21 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 150821260 150821260 NLM34112089 150821260 10.1186/s12872-021-02096-1 NLM34112089 150821260 ppf: 1 ppct: 9 formats: tig: atl: An electrographic AV optimization for the maximum integrative atrioventricular and ventricular resynchronization in CRT. aug: au: Li, Jie Wang, Yuegang Mai, Jingting Chen, Shilan Liu, Menghui Su, Chen Chen, Xumiao Huang, Huiling Ma, Yuedong Feng, Chong Jiang, Jingzhou Liu, Jun He, Jiangui Tang, Anli Dong, Yugang Huang, Xiaobo Chen, Yangxin Wang, Lichun affil: Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan 2nd Rd, 510080, Guangzhou, Guangdong, People's Republic of China sug: subj: Cardiac Resynchronization Therapy Heart Function Tests Electrocardiography Arrhythmia Therapy Heart Rate Action Potentials Female Arrhythmia Diagnosis Signal Processing, Computer Assisted Recovery Time Factors Cross Sectional Studies Arrhythmia Physiopathology Treatment Outcomes Middle Age Human Male Predictive Value of Tests Aged China Comparative Studies Multicenter Studies Evaluation Research Validation Studies Middle Aged: 45-64 years Aged: 65+ years Female Male ab: Background: Atrioventricular (AV) delay could affect AV and ventricular synchrony in cardiac resynchronization therapy (CRT). Strategies to optimize AV delay according to optimal AV synchrony (AVopt-AV) or ventricular synchrony (AVopt-V) would potentially be discordant. This study aimed to explore a new AV delay optimization algorithm guided by electrograms to obtain the maximum integrative effects of AV and ventricular resynchronization (opt-AV).Methods: Forty-nine patients with CRT were enrolled. AVopt-AV was measured through the Ritter method. AVopt-V was obtained by yielding the narrowest QRS. The opt-AV was considered to be AVopt-AV or AVopt-V when their difference was < 20 ms, and to be the AV delay with the maximal aortic velocity-time integral between AVopt-AV and AVopt-V when their difference was > 20 ms.Results: The results showed that sensing/pacing AVopt-AV (SAVopt-AV/PAVopt-AV) were correlated with atrial activation time (Pend-As/Pend-Ap) (P < 0.05). Sensing/pacing AVopt-V (SAVopt-V/PAVopt-V) was correlated with the intrinsic AV conduction time (As-Vs/Ap-Vs) (P < 0.01). The percentages of patients with more than 20 ms differences between SAVopt-AV/PAVopt-AV and SAVopt-V/PAVopt-V were 62.9% and 57.1%, respectively. Among them, opt-AV was linearly correlated with SAVopt-AV/PAVopt-AV and SAVopt-V/PAVopt-V. The sensing opt-AV (opt-SAV) = 0.1 × SAVopt-AV + 0.4 × SAVopt-V + 70 ms (R2 = 0.665, P < 0.01) and the pacing opt-AV (opt-PAV) = 0.25 × PAVopt-AV + 0.5 × PAVopt-V + 30 ms (R2 = 0.560, P < 0.01).Conclusion: The SAVopt-AV/PAVopt-AV and SAVopt-V/PAVopt-V were correlated with the atrial activation time and the intrinsic AV conduction interval respectively. Almost half of the patients had a > 20 ms difference between SAVopt-AV/PAVopt-AV and SAVopt-V/PAVopt-V. The opt-AV could be estimated based on electrogram parameters. pubtype: Academic Journal doctype: research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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