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November 4, 2009EP EuropaceOpen Access

A prospective comparison of echocardiography and device algorithms for atrioventricular and interventricular interval optimization in cardiac resynchronization therapy

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Key result

Echocardiographic optimization of AV and VV intervals yielded a superior haemodynamic outcome compared to the QuickOpt algorithm, with better LVOT VTI in 22 of 26 patients (P<0.001).

Why the study?

Does the QuickOpt automated device algorithm provide comparable AV and VV interval optimization and hemodynamic outcomes compared to echocardiographic optimization in heart failure patients with CRT?

Population

26 patients with heart failure, assessed one month after cardiac resynchronization therapy device implantation

Comparison

Automated device algorithm for atrioventricular… vs Echocardiographic optimization of AV and VV…

Design

Cohort

Follow-up

1 month post-implantation

Authors

RKR. KamdarNarsee Monjee Institute of Management StudiesEFE. FrainSt Bartholomew's HospitalFWF. G. WarburtonSt Bartholomew's Hospital

Discussion

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Implication

Echo optimization may improve acute hemodynamics over QuickOpt; leaves open long-term clinical benefit in CRT.

Study Design

Type

Observational (n=26)

Structured PICO

Does the QuickOpt automated device algorithm provide comparable AV and VV interval optimization and hemodynamic outcomes compared to echocardiographic optimization in heart failure patients with CRT?

P
Population
26 patients with heart failure evaluated one month after CRT device implantation to compare optimization techniques.
I
Intervention
Automated device algorithm (QuickOpt) for atrioventricular (AV) and interventricular (VV) interval optimization
C
Comparator
Echocardiographic optimization of AV and VV intervals
O
Outcome
Left ventricular outflow tract (LVOT) velocity-time integral (VTI) and agreement in optimal AV and VV intervalssurrogate

Main Result

p-value: p=<0.001

Echocardiographic optimization of CRT devices yields superior hemodynamic outcomes compared to the automated QuickOpt algorithm, highlighting the continued value of echocardiography in CRT tuning.

Cite This Study

Kamdar et al. (2009) conducted an observational in Heart failure (n=26). QuickOpt algorithm vs. Echocardiographic optimization was evaluated on Left ventricular outflow tract (LVOT) velocity-time integral (VTI) (p=<0.001). Echocardiographic optimization of AV and VV intervals yielded a superior haemodynamic outcome compared to the QuickOpt algorithm, with better LVOT VTI in 22 of 26 patients (P<0.001).

synapsesocial.com/papers/6a6a44afba3b67e10e44a712https://doi.org/10.1093/europace/eup337

Topics

EchocardiographyHFrEF treatmentHeart failure
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiac Resynchronization Therapy: Variations in Echo‐Guided Optimized Atrioventricular and Interventricular Delays During Follow‐Up2007 · 54 citations
  2. 2A Prospective Comparison of AV Delay Programming Methods for Hemodynamic Optimization during Cardiac Resynchronization Therapy2007 · 111 citations
  3. 3Atrioventricular Delay Optimization by Doppler‐Derived Left Ventricular dP/dt Improves 6‐Month Outcome of Resynchronized Patients2006 · 105 citations
  4. 4Haemodynamic effects of changes in atrioventricular and interventricular delay in cardiac resynchronisation therapy show a consistent pattern: analysis of shape, magnitude and relative importance of atrioventricular and interventricular delay2006 · 138 citations
  5. 5Prediction of Optimal Atrioventricular Delay in Patients with Implanted DDD Pacemakers1999 · 87 citations