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Comparison of Hemodynamic versus Dyssynchrony Assessment for Interventricular Delay Optimization with Echocardiography in Cardiac Resynchronization Therapy
Author(s) -
DOLTRA ADELINA,
VIDAL BÀRBARA,
SILVA ETELVINO,
MONT LLUÍS,
TAMBORERO DAVID,
CASTEL MARÍA ÁNGELES,
TOLOSANA JOSÉ MARÍA,
BERRUEZO ANTONIO,
BRUGADA JOSEP,
SITGES MARTA
Publication year - 2011
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.1540-8159.2011.03078.x
Subject(s) - medicine , cardiac resynchronization therapy , ventricular outflow tract , cardiology , hemodynamics , doppler imaging , doppler echocardiography , haemodynamic response , heart failure , ejection fraction , heart rate , diastole , blood pressure
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)