Cardiac resynchronization using fusion pacing during exercise.
Introduction: Fusion pacing requires correct timing of left ventricular pacing to right ventricular activation, although it is unclear whether this is maintained when atrioventricular (AV) conduction changes during exercise. We used cardiopulmonary exercise testing (CPET) to compare cardiac resynchr...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 35; no. 1; pp. 146 - 155 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts tracings randomized controlled trial Journal Article |
| Publicado: |
Wiley-Blackwell
Jan2024
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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=174690500&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 174690500 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jan2024 vid: 35 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 174690500 173816348 174690500 174690500 10.1111/jce.16120 174690500 ppf: 146 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Cardiac resynchronization using fusion pacing during exercise. aug: au: Green, Peregrine G. Monteiro, Cristiana Holdsworth, David A. Betts, Timothy R. Herring, Neil affil: Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre, University of Oxford, Oxford, UK sug: subj: Cardiac Resynchronization Therapy Methods Cardiac Pacing, Artificial Methods Exercise Test, Cardiopulmonary Outcome Assessment Human Randomized Controlled Trials Random Assignment Descriptive Statistics Double-Blind Studies Male Female Aged QRS Complex Oxygen Consumption Anaerobic Threshold Algorithms Funding Source Aged: 65+ years Male Female ab: Introduction: Fusion pacing requires correct timing of left ventricular pacing to right ventricular activation, although it is unclear whether this is maintained when atrioventricular (AV) conduction changes during exercise. We used cardiopulmonary exercise testing (CPET) to compare cardiac resynchronization therapy (CRT) using fusion pacing or fixed AV delays (AVD). Methods: Patients 6 months post‐CRT implant with PR intervals < 250 ms performed two CPET tests, using either the SyncAV™ algorithm or fixed AVD of 120 ms in a double‐blinded, randomized, crossover study. All other programming was optimized to produce the narrowest QRS duration (QRSd) possible. Results: Twenty patients (11 male, age 71 [65–77] years) were recruited. Fixed AVD and fusion programming resulted in similar narrowing of QRSd from intrinsic rhythm at rest (p =.85). Overall, there was no difference in peak oxygen consumption (V̇O2PEAK, p =.19), oxygen consumption at anaerobic threshold (VT1, p =.42), or in the time to reach either V̇O2PEAK (p =.81) or VT1 (p =.39). The BORG rating of perceived exertion was similar between groups. CPET performance was also analyzed comparing whichever programming gave the narrowest QRSd at rest (119 [96–136] vs. 134 [119–142] ms, p <.01). QRSd during exercise (p =.03), peak O2 pulse (mL/beat, a surrogate of stroke volume, p =.03), and cardiac efficiency (watts/mL/kg/min, p =.04) were significantly improved. Conclusion: Fusion pacing is maintained during exercise without impairing exercise capacity compared with fixed AVD. However, using whichever algorithm gives the narrowest QRSd at rest is associated with a narrower QRSd during exercise, higher peak stroke volume, and improved cardiac efficiency. pubtype: Academic Journal doctype: research tables/charts tracings randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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