Premium
Long‐Term Variations in Optimal Programming of Cardiac Resynchronization Therapy Devices
Author(s) -
O'DONNELL D.,
NADURATA V.,
HAMER A.,
KERTES P.,
MOHAMMED U.
Publication year - 2005
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2005.00070.x
Subject(s) - cardiac resynchronization therapy , medicine , implant , cardiology , heart failure , surgery , ejection fraction
The optimal follow‐up and long‐term programming of cardiac resynchronization therapy (CRT) devices are uncertain. The aim of this study was to quantify the temporal variations in programming parameters to optimize the follow‐up of these devices. Before, during, and at specified intervals over 9 months after implant, 40 recipients of CRT devices were studied. At each visit, the patients were tested with a fixed sequence of stimulation parameters during echocardiographic and electrocardiographic (ECG) recordings. The optimal AV delay and inter‐ventricular delays (V‐V) were determined according to echocardiographic criteria. The echocardiographic data were, in turn, compared with the ECG recordings. Among the 40 patients, the optimal stimulation parameters remained unchanged throughout the follow‐up in only three patients. In 18 patients, adjustments were required at each follow‐up sessions. There was a trend toward reduction in the left ventricular (LV) predominance of the optimal V‐V delay and an increase in the AV delay during follow‐up. The mean optimal V‐V delay at implant was 22 ms (−12 to +32 ms) with the LV activated first, versus 12 ms (−16 to +32 ms) at 9 months. The mean AV delay at implant was 115 ms versus 137 ms at 9 months. Individual changes could not be accurately predicted. The optimal stimulation parameters for CRT vary over time. Detailed, regular reevaluations, and reprogramming of optimal parameters may be appropriate.