Key result
Adaptive CRT improves response and reduces morbidity and mortality in patients with normal AV conduction.
Why the study?
Optimal programming of AV and VV delays in CRT is crucial but echocardiogram-based optimization is resource-dependent and time consuming, motivating evaluation of adaptive CRT algorithms.
Does the Adaptive CRT (aCRT) algorithm improve CRT response and reduce morbidity and mortality in CRT-indicated patients without permanent atrial fibrillation?
Does the Adaptive CRT (aCRT) algorithm improve CRT response and reduce morbidity and mortality in CRT-indicated patients without permanent atrial fibrillation?
The aCRT algorithm provides dynamic, automatic adjustment of CRT pacing and optimization of AV/VV delays, improving outcomes in CRT-indicated patients with normal AV conduction.
May support aCRT in normal AV conduction; leaves open confirmation in prospective RCTs.
Cardiac resynchronization therapy (CRT) is a well-established therapy to reduce morbidity and mortality in patients with moderate and severe symptomatic congestive heart failure. Left ventricular (LV) pacing that fuses with intrinsic right ventricular (RV) conduction results in similar or even better cardiac performance compared to biventricular (Biv) pacing. Optimal programming of the atrio-ventricular (AV) and inter-ventricular (VV) delays is crucial to improve LV performance since suboptimal programming of AV and VV delays affect LV filling as well as cardiac output. CRT optimization using echocardiogram is resource-dependent and time consuming. Adaptive CRT (aCRT) algorithm provides a dynamic, automatic, ambulatory adjustment of CRT pacing configuration (Biv or LV pacing) and optimization of AV and VV delays. aCRT algorithm is safe and efficacious for CRT-indicated patients without permanent atrial fibrillation. It has been shown to improve CRT response and reduce morbidity and mortality for patients with normal AV conduction.
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Houmsse et al. (2014) conducted a review in Moderate and severe symptomatic congestive heart failure. Adaptive CRT (aCRT) algorithm was evaluated. The adaptive CRT (aCRT) algorithm provides dynamic adjustment of pacing configuration and has been shown to improve CRT response and reduce morbidity and mortality for patients with normal AV conduction.
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