Comparison of different invasive hemodynamic methods for AV delay optimization in patients with cardiac resynchronization therapy: Implications for clinical trial design and clinical practice

Autor: Arnaud Denis, Irene E. van Geldorp, Patrizio Pascale, Zachary I. Whinnett, Philippe Ritter, Michel Haïssaguerre, Sylvain Ploux, Darrel P. Francis, Maxime De Guillebon, Keith Willson, Kenneth A. Ellenbogen, Pierre Bordachar
Přispěvatelé: British Heart Foundation
Rok vydání: 2013
Předmět:
Male
Cardiac & Cardiovascular Systems
medicine.medical_treatment
Hemodynamics
Ventricular Function
Left
Electrocardiography
Medicine
Cardiac resynchronization therapy
medicine.diagnostic_test
Atrioventricular delay optimization
Dilated cardiomyopathy
Av delay
Middle Aged
Atrioventricular node
Reproducibility
Treatment Outcome
medicine.anatomical_structure
Atrioventricular Node
cardiovascular system
Cardiology
HEART-FAILURE
Female
Cardiology and Cardiovascular Medicine
Life Sciences & Biomedicine
circulatory and respiratory physiology
Adult
medicine.medical_specialty
Heart Ventricles
1102 Cardiovascular Medicine And Haematology
Article
Internal medicine
Humans
Aged
Heart Failure
Science & Technology
business.industry
Clinical study design
ATRIOVENTRICULAR DELAY
Reproducibility of Results
Biventricular pacing
DILATED CARDIOMYOPATHY
medicine.disease
Cardiovascular System & Hematology
Heart failure
Cardiovascular System & Cardiology
Hemodynamic optimization
business
Follow-Up Studies
Zdroj: International Journal of Cardiology
ISSN: 0167-5273
Popis: Background Reproducibility and hemodynamic efficacy of optimization of AV delay (AVD) of cardiac resynchronization therapy (CRT) using invasive LV dp/dtmax are unknown. Method and results 25 patients underwent AV delay (AVD) optimisation twice, using continuous left ventricular (LV) dp/dtmax, systolic blood pressure (SBP) and pulse pressure (PP). We compared 4 protocols for comparing dp/dtmax between AV delays:Immediate absolute: mean of 10 s recording of dp/dtmax acquired immediately after programming the tested AVD,Delayed absolute: mean of 10 s recording acquired 30 s after programming AVD,Single relative: relative difference between reference AVD and the tested AVD,Multiple relative: averaged difference, from multiple alternations between reference and tested AVD. We assessed for dp/dtmax, LVSBP and LVPP, test–retest reproducibility of the optimum. Optimization using immediate absolute dp/dtmax had poor reproducibility (SDD of replicate optima = 41 ms; R2 = 0.45) as did delayed absolute (SDD 39 ms; R2 = 0.50). Multiple relative had better reproducibility: SDD 23 ms, R2 = 0.76, and (p
Databáze: OpenAIRE
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