Feasibility of a novel atrioventricular delay optimization method using transmitral and pulmonary venous flow in patients with sequential ventricular pacing or cardiac resynchronization therapyReport as inadecuate




Feasibility of a novel atrioventricular delay optimization method using transmitral and pulmonary venous flow in patients with sequential ventricular pacing or cardiac resynchronization therapy - Download this document for free, or read online. Document in PDF available to download.

Journal of Echocardiography

, Volume 13, Issue 2, pp 52–58

First Online: 19 December 2014Received: 23 April 2014Revised: 07 November 2014Accepted: 25 November 2014

Abstract

BackgroundAlthough several echo-Doppler methods were proposed to optimize atrioventricular AV delay in patients with sequential ventricular pacing -echo-guided- AV optimization has not been widely adopted clinically. A combination of trasmitral flow TMF and pulmonary venous flow PVF measurements may be beneficial to further optimize AV delay to achieve better cardiac function. The aim of this study was to assess the feasibility and usefulness of AV delay optimization by combined use of TMF and PVF.

MethodsA total of 32 patients after sequential ventricular pacemaker implantation were enrolled and studied. The optimal AV delay was defined as the timing to minimize the duration between PVF reversal a wave and the duration of the -A- wave of TMF. Stroke volume was measured at the -optimized- AV delay AVDOPT and was compared with that obtained at shorter AVDOPT − 50 ms and longer AVDOPT + 50 ms AV delays.

ResultsAV optimization was feasible in 27 of 32 patients 87 %. Stroke volume at AVDOPT was significantly higher than that at shorter or longer AV delay 63 ± 18 ml vs. 57 ± 15 ml vs. 56 ± 16 ml, P = 0.001.

ConclusionsAV delay optimization using TMF and PV flow was feasible. Usefulness of this method requires further investigation with a larger study population.

KeywordsDoppler echocardiography Left ventricular function Pacemaker Cardiac resynchronization therapy AV delay  Download fulltext PDF



Author: Kenzo Fukuhara - Hiroyuki Okura - Terumasa Koyama - Teruyoshi Kume - Yoji Neishi - Akihiro Hayashida - Kiyoshi Yoshida

Source: https://link.springer.com/



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