Echocardiographic examination of atrioventricular and interventricular delay optimization in cardiac resynchronization therapy.

In 21 patients implanted with a biventricular pacing device with programmable interventricular delay (VVd), the myocardial performance index (MPI) was evaluated during spontaneous sinus rhythm, simultaneous biventricular pacing, and sequential biventricular pacing at different VVds and atrioventricular delays (AVds). The AVd-VVd combination associated with the minimum MPI defined patient-tailored biventricular pacing. Simultaneous biventricular pacing significantly improved MPI compared with spontaneous sinus rhythm. An additional improvement was obtained by tailored biventricular pacing. The optimal AVds were significantly shorter during right ventricular preactivation than during left ventricular preactivation.

[1]  B. Kristensen,et al.  Sequential Versus Simultaneous Biventricular Resynchronization for Severe Heart Failure: Evaluation by Tissue Doppler Imaging , 2002, Circulation.

[2]  C. H. Chen,et al.  Improved left ventricular mechanics from acute VDD pacing in patients with dilated cardiomyopathy and ventricular conduction delay. , 1999, Circulation.

[3]  Albert Meijer,et al.  Effect of optimizing the VV interval on left ventricular contractility in cardiac resynchronization therapy. , 2004, The American journal of cardiology.

[4]  C A Bucknall,et al.  Non-contact left ventricular endocardial mapping in cardiac resynchronisation therapy , 2003, Heart.

[5]  Chu-Pak Lau,et al.  Predictors of left ventricular reverse remodeling after cardiac resynchronization therapy for heart failure secondary to idiopathic dilated or ischemic cardiomyopathy. , 2003, The American journal of cardiology.

[6]  C. Tei,et al.  New non-invasive index for combined systolic and diastolic ventricular function. , 1995, Journal of cardiology.

[7]  M. Facchini,et al.  Simultaneous vs. sequential biventricular pacing in dilated cardiomyopathy: an acute hemodynamic study , 2003, European journal of heart failure.

[8]  J B Seward,et al.  Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. , 1997, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[9]  L. Padeletti,et al.  A Perspective on Atrioventricular Delay Optimization in Patients with a Dual Chamber Pacemaker , 2004, Pacing and clinical electrophysiology : PACE.

[10]  Andrew P. Kramer,et al.  Effect of pacing chamber and atrioventricular delay on acute systolic function of paced patients with congestive heart failure. The Pacing Therapies for Congestive Heart Failure Study Group. The Guidant Congestive Heart Failure Research Group. , 1999, Circulation.