Echocardiography-Guided Biventricular Pacemaker Optimization

Naqvi, Tasneem Z.

doi:10.1016/j.jcmg.2010.06.017

Cited by 19 publications

(16 citation statements)

References 51 publications

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“…Echocardiography-guided optimization has several advantages, including the noninvasive nature of the procedure, reliability and good clinical outcomes. 30 The procedure is limited by its high cost and the length of time required to perform it, which both lead to poor compliance in some patients. In addition, accuracy and consistency are affected by the operational performance of technicians.…”

Section: Discussionmentioning

confidence: 99%

Long-term clinical effects of programmer-guided atrioventricular and interventricular delay optimization: Intracardiac electrography versus echocardiography for cardiac resynchronization therapy in patients with heart failure

Wang

Tian

et al. 2013

J Int Med Res

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Section: Discussionmentioning

confidence: 99%

Long-term clinical effects of programmer-guided atrioventricular and interventricular delay optimization: Intracardiac electrography versus echocardiography for cardiac resynchronization therapy in patients with heart failure

Wang

Tian

et al. 2013

J Int Med Res

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“…It also indicates decreases in mitral regurgitation and the adequacy of the programmed atrioventricular delay. 14 Pacemaker timing intervals, which are important in biventricular pacing, include atrioventricular delay, a parameter that starts with the atrial event and then is programmed to determine the time to ventricular response. Atrioventricular delay is programmed for each patient to optimize synchrony of left and right ventricular contraction.…”

Section: Resultsmentioning

confidence: 99%

Biventricular Pacemakers in Patients With Heart Failure

Cooper

2015

Critical Care Nurse

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H eart failure is a debilitating chronic condition that affects more than 5 million patients in the United States. 1 The condition is complex and incurable, but multiple medications, procedures, and devices are available to treat it. Biventricular pacing, a therapy for some patients with heart failure, can improve quality of life and reduce the number of hospitalizations and mortality. 2,3 In this article, I discuss selection of patients and devices, the procedure used to implant the pacemaker, potential complications, and assessment of the function of biventricular pacemakers. Nurses who provide care for patients with permanent pacemakers and biventricular pacemakers should be knowledgeable in the assessment of electrocardiographic (ECG) findings related to adequate functioning of biventricular pacemakers. In addition, I provide bedside critical care or telemetry nurses the information to determine if a biventricular pacemaker is functioning and when to contact a cardiologist to determine if further interrogation of the pacemaker or correction of timing is needed. Indications for Biventricular Pacing in Heart FailureMultiple indications exist for implanting a biventricular pacemaker in patients with heart failure, and the indications are continuously being reevaluated to include a broader range of patients with the diagnosis of heart failure. According to the Heart Failure Society of America, biventricular pacing is recommended for patients with sinus rhythm, a widened QRS interval greater than 120 ms, and a left CE Continuing Nursing EducationCover Patients with heart failure may benefit from implantation of a biventricular pacemaker. This article discusses the indications for biventricular pacemaker implantation and the assessment of patients with biventricular pacemakers. Biventricular pacemakers require more assessments than do traditional single-or dualchamber pacemakers. (Critical Care Nurse. 2015;35[2]:20-28)

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“…Optimal AV/VV delays are therefore those intervals that maximize VTI. Echocardiography-guided optimization has several advantages, including the noninvasive nature of the procedure, higher reliability, and better clinical outcomes [17]. QRS narrowing may reflect correction of electrical dyssynchrony, but this is considered as an oversimplified surrogate marker of mechanical dyssynchrony [18].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effect of Different Optimizing Methods for Cardiac Resynchronization Therapy in Patients with Heart Failure: A Randomized and Controlled Pilot Study

et al. 2019

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Aim: During cardiac resynchronization therapy (CRT), optimized programming of the atrioventricular (AV) delay and ventricular-to-ventricular (VV) interval can lead to improved hemodynamics, symptomatic response, and left ventricular systolic function. Currently, however, there is no recommendation for the best optimization method. This study aimed to compare the long-term clinical outcomes of 4 different CRT optimization methods. Methods: One hundred and twenty-four consecutive CRT patients with severe heart failure and left bundle-branch block configuration were randomly assigned into four groups to undergo AV/VV delay optimization through echocardiogram (ECHO; n = 30), electrocardiogram (ECG; n = 32), QuickOpt algorithm (n = 28), and nominal AV/VV (n = 36) groups. Patients were followed up and underwent examinations, including New York Heart Association (NYHA) cardiac functional classification, 6-min walking distance (6MWD), and echocardiography, at 6, 12, 24, 36, and 48 months, respectively. The patients’ survival and clinical outcomes were compared among the four groups. Results: Kaplan-Meier survival analyses showed that the median survival was the same in the 4 groups: ECHO, 43 months; ECG, 44 months; QuickOpt, 44 months, and nominal, 41 months. At the 6-month follow-up, the reduction in left ventricular end diastolic diameter (LVEDD) was significantly less in the nominal group (–1.91 ± 2.58 mm) than that in the other three groups (ECHO: –3.70 ± 2.78 mm, p = 0.012; ECG: –3.53 ± 3.14 mm, p = 0.020; QuickOpt: –3.46 ± 2.65 mm, p = 0.032); 6MWD was significantly shorter in the nominal group (87.88 ± 34.76 m) than that in the other three groups (ECHO: 120.63 ± 56.93 m, p = 0.006; ECG: 114.97 ± 54.95 m, p = 0.020; QuickOpt: 114.57 ± 35.41 m, p = 0.027). Left ventricular ejection fraction (LVEF) significantly increased in ECHO (7.23 ± 2.76%, p = 0.010), ECG (8.50 ± 3.17%, p < 0.001), and QuickOpt (8.39 ± 2.90%, p < 0.001) compared with the nominal group (5.35 ± 2.59%). There were no significant differences among the groups in the aforementioned parameters at 24, 36, and 48 months, respectively. Conclusion: While LVEDD, LVEF, 6MWD, and NYHA were significantly improved in ECHO, ECG, and QuickOpt at 6 months, there were no significant improvements in any of the groups at 12, 24, and 48 months. These findings suggested that the long-term effect of the four CRT methods for heart failure was not significantly different.

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Echocardiography-Guided Biventricular Pacemaker Optimization

Cited by 19 publications

References 51 publications

Long-term clinical effects of programmer-guided atrioventricular and interventricular delay optimization: Intracardiac electrography versus echocardiography for cardiac resynchronization therapy in patients with heart failure

Long-term clinical effects of programmer-guided atrioventricular and interventricular delay optimization: Intracardiac electrography versus echocardiography for cardiac resynchronization therapy in patients with heart failure

Biventricular Pacemakers in Patients With Heart Failure

Long-Term Effect of Different Optimizing Methods for Cardiac Resynchronization Therapy in Patients with Heart Failure: A Randomized and Controlled Pilot Study

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