The SyncAV algorithm with optimized offset significantly reduced QRS duration to 134.8 ms compared to 153.1 ms with QuickOpt and 172.8 ms during intrinsic conduction (P<0.01).
Observational (n=35)
Does the SyncAV algorithm improve electrical and mechanical synchrony and acute hemodynamic response compared to the QuickOpt algorithm in patients undergoing CRT?
The SyncAV algorithm, particularly with individualized offset optimization, improves acute electrical and mechanical synchrony and hemodynamic response beyond conventional QuickOpt optimization in CRT patients.
Absolute Event Rate: 134.8% vs 153.1%
p-value: p=<0.01
Abstract Introduction Several automatic algorithms have developed to optimize the timing cycle setting in cardiac resynchronization therapy (CRT). The present study aims to investigate whether the novel device‐based SyncAV algorithm could elicit better synchrony and acute hemodynamic response. Methods and Results Thirty five patients undergoing CRT implantation were prospectively studied. The device was programmed to three biventricular (BiV) pacing modes sequentially after the procedure: QuickOpt algorithm (mode I), SyncAV algorithm with default 50 ms offset (mode II), and SyncAV algorithm with optimized offset minimizing QRS duration (QRSd) (mode III). After each setting, electrocardiographic and echocardiographic data were collected. As a result, QRSd was reduced from 172.8 ± 17.9 ms during intrinsic conduction to 153.1 ± 15.9 ms in mode I, further narrowed to 140.5 ± 16.7 ms in mode II, and reached shortest (134.8 ± 16.1 ms) in mode III ( P .05). Mode I presented significantly higher aortic velocity time integral than intrinsic conduction (21.0 ± 6.4 cm vs 18.4 ± 5.5 cm; P < .01), which was even higher in mode II (22.0 ± 6.5 cm) and mode III (23.7 ± 6.5 cm). All three BiV modes significantly reduced standard deviation of time to peak contraction of 12‐LV segments (Ts‐SD) (Mode I: 55.2 ± 16.5 ms, Mode II: 50.2 ± 14.7 ms, Mode III: 45.4 ± 14.4 ms) compared with intrinsic conduction (66.3 ± 18.4 ms) ( P < .01), with Mode III demonstrating the smallest ( P < .01). Conclusion SyncAV CRT ameliorated electrical and mechanical synchrony as well as acute hemodynamic response beyond conventional QuickOpt optimization. An additional individualized adjustment to the SyncAV offset added to its advantage.
Wang et al. (2019) conducted an observational in Heart failure (n=35). SyncAV algorithm vs. QuickOpt algorithm and intrinsic conduction was evaluated on QRS duration (QRSd) (p=<0.01). The SyncAV algorithm with optimized offset significantly reduced QRS duration to 134.8 ms compared to 153.1 ms with QuickOpt and 172.8 ms during intrinsic conduction (P<0.01).