Right ventricular contractility as a measure of optimal interventricular pacing setting in cardiac resynchronization therapy
| Autor: | Carina Blomström Lundqvist, Per Blomström, Stefan Lönnerholm, Elena Sciaraffia, Helena Malmborg |
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| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Manometry Ventricular Dysfunction Right medicine.medical_treatment Cardiac resynchronization therapy Hemodynamics Sensitivity and Specificity Intracardiac injection Contractility Physiology (medical) Internal medicine Humans Medicine In patient Ventricular contractility business.industry Cardiac Pacing Artificial Reproducibility of Results Middle Aged Biventricular pacemaker Treatment Outcome Therapy Computer-Assisted Tachycardia Ventricular Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Europace. 11:1496-1500 |
| ISSN: | 1532-2092 1099-5129 |
| DOI: | 10.1093/europace/eup288 |
| Popis: | Aims The aim of the present study was to assess whether right ventricular (RV) contractility can be used for optimization of the interventricular (VV) interval and to study the acute hemodynamic effect of different VV intervals on right and left ventricular (LV) contractility in patients referred for cardiac resynchronization therapy (CRT). Methods and results Intracardiac LV and RV d P /d t were measured with a 0.014-in. sensor-tipped pressure guidewire during pacing at nine different VV intervals ranging from +80 ms (LV pre-excitation) to −80 ms (RV pre-excitation) in 26 patients who received a biventricular pacemaker. No correlation was found between the optimal VV intervals identified by maximum LV d P /d t and RV d P /d t , which were identical in only seven cases (27%). Only when testing slightly broader intervals (±20 ms) was there a statistically significant correlation ( P = 0.037) between the optimized VV intervals. In the majority of patients (58%) either LV or RV pre-excitation was superior to simultaneous pacing according to LV d P /d t max measurements. Conclusion RV d P /d t max failed to identify the optimal VV interval when compared with LV d P /d t max and can therefore not be recommended for VV optimization in CRT patients. |
| Databáze: | OpenAIRE |
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