Comparison of Hemodynamic versus Dyssynchrony Assessment for Interventricular Delay Optimization with Echocardiography in Cardiac Resynchronization Therapy

被引:9
|
作者
Doltra, Adelina [1 ]
Vidal, Barbara [1 ]
Silva, Etelvino [1 ]
Mont, Lluis [1 ]
Tamborero, David [1 ]
Angeles Castel, Maria [1 ]
Maria Tolosana, Jose [1 ]
Berruezo, Antonio [1 ]
Brugada, Josep [1 ]
Sitges, Marta [1 ]
机构
[1] Univ Barcelona, IDIBAPS, Hosp Clin, Thorax Clin Inst, Barcelona, Spain
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2011年 / 34卷 / 08期
关键词
cardiac resynchronization therapy; optimization; echocardiography; BUNDLE-BRANCH BLOCK; SEVERE HEART-FAILURE; RHYTHM-II ICD; VENTRICULAR DYSSYNCHRONY; TRIAL;
D O I
10.1111/j.1540-8159.2011.03078.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Best practice for cardiac resynchronization therapy (CRT) device optimization is not established. This study compared Tissue Doppler Imaging (TDI) to study left ventricular (LV) synchrony and left ventricular outflow tract velocity-time integral (LVOT VTI) to assess hemodynamic performance. Methods: LVOT VTI and LV synchrony were tested in 50 patients at three interventricular (VV) delays (LV preactivation at -30 ms, simultaneous biventricular pacing, and right ventricular preactivation at +30 ms), selecting the highest VTI and the greatest degree of superposition of the displacement curves, respectively, as the optimum VV delay. Results: In 39 patients (81%), both techniques agreed (Kappa = 0.65, p < 0.0001) on the optimum VV delay. LV preactivation (VV - 30) was the interval most frequently chosen. Conclusions: Both TDI and LVOT VTI are useful CRT programming methods for VV optimization. The best hemodynamic response correlates with the best synchrony. In most patients, the optimum VV interval is LV preactivation. (PACE 2011;34:984-990)
引用
收藏
页码:984 / 990
页数:7
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