Effect of optimizing the VV interval on left ventricular contractility in cardiac resynchronization therapy

Gelder, Berry M. van; Bracke, Frank; Meijer, Albert; Lakerveld, Lex J.M; Pijls, Nico H.J.

doi:10.1016/j.amjcard.2004.02.061

Cited by 230 publications

(165 citation statements)

References 12 publications

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“…Some invasive studies assessing the hemodynamic response to VV programming have demonstrated that sequential biventricular pacing is more effective than simultaneous biventricular pacing [19,20]. Similar fi ndings were reported by Marsan et al [21].…”

Section: Vv Delaysupporting

confidence: 78%

Whether noninvasive optimization of AV and VV delays improves the response to cardiac resynchronization therapy

Urbanek

Chudzik²,

Klimczak³

et al. 2013

Cardiol J

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Section: Vv Delaysupporting

confidence: 78%

Whether noninvasive optimization of AV and VV delays improves the response to cardiac resynchronization therapy

Urbanek

Chudzik²,

Klimczak³

et al. 2013

Cardiol J

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“…It is possible that if some parameters were optimized (eg, VV conduction and the stimulus strength of left ventricular pacing), the number of non-responders would be decreased. 28,29) Finally, there are no recognized criteria for defining a non-responder by the results of CRT. Our definition of a non-responder may have had inherent weaknesses.…”

Section: Discussionmentioning

confidence: 99%

Effects of Cardiac Resynchronization Therapy on Ventricular Electrical Remodeling in Patients With Heart Failure

et al. 2015

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SummaryCardiac resynchronization therapy (CRT) reverses structural remodeling of the left ventricle. We investigated whether CRT reverses left-ventricular electrical remodeling.Eighty patients were enrolled and implanted with CRT-devices. Echocardiography and electrocardiography data were obtained from each patient prior to implantation and two years after implantation. At two years after implantation, the patients were classified into a responder group and a non-responder group based on echocardiography.Over the next 2 years, 75 patients completed follow-up, and 5 patients had died. Echocardiography results showed that 23 patients could be classified as non-responders and 52 as responders. Larger numbers of non-responders were diagnosed with either ischemic cardiomyopathy (ICM) or nonspecific intraventricular conduction delay (NICD). The intrinsic QRS duration was not changed in responders, patients with dilated cardiomyopathy, or in the patient categories of male and female. However, the intrinsic QRS duration was significantly prolonged in non-responders and patients with ischemic cardiomyopathy (P = 0.041). The mean left ventricular end-diastolic diameter in the responder group was significantly decreased by CRT (P < 0.05), while there was no significant change in intrinsic QRS duration.While CRT does not reduce the intrinsic QRS duration, it can delay negative ventricular electrical remodeling. Continuous CRT is necessary. (Int Heart J 2015; 56: 495-499)

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“…Each section of the peripheral circulation is represented by a Windkessel model [6,13]. For each section of the circulatory model ( Fig.1), the input flow is transmitted from the previous block, while the output flow and the generated pressure are calculated and transmitted to the next block as it is described by the following equations:…”

Section: The Numerical Model Of the Cardiovascular Systemmentioning

confidence: 99%

Towards a Personalized and Dynamic CRT-D

Molfetta

Santini²,

Forleo³

et al. 2012

Methods Inf Med

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SummaryBackground: In spite of cardiac resynchronization therapy (CRT) benefits, 25 -30% of patients are still non responders. One of the possible reasons could be the non optimal atrioventricular (AV) and interventricular (VV) intervals settings. Our aim was to exploit a numerical model of cardiovascular system for AV and VV intervals optimization in CRT. Methods: A numerical model of the cardiovascular system CRT-dedicated was previously developed. Echocardiographic parameters, Systemic aortic pressure and ECG were collected in 20 consecutive patients before and after CRT. Patient data were simulated by the model that was used to optimize and set into the device the intervals at the baseline and at the follow up. The optimal AV and VV intervals were chosen to optimize the simulated selected variable/s on the base of both echocardiographic and electrocardiographic parameters. Results: Intervals were different for each patient and in most cases, they changed at follow up. The model can well reproduce clinical data as verified with Bland Altman analysis and T-test (p > 0.05). Left ventricular remodeling was 38.7% and left ventricular ejection fraction increasing was 11% against the 15% and 6% reported in literature, respectively. Conclusions: The developed numerical model could reproduce patients conditions at the baseline and at the follow up including the CRT effects. The model could be used to optimize AV and VV intervals at the baseline and at the follow up realizing a personalized and dynamic CRT. A patient tailored CRT could improve patients outcome in comparison to literature data.

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Effect of optimizing the VV interval on left ventricular contractility in cardiac resynchronization therapy

Cited by 230 publications

References 12 publications

Whether noninvasive optimization of AV and VV delays improves the response to cardiac resynchronization therapy

Whether noninvasive optimization of AV and VV delays improves the response to cardiac resynchronization therapy

Effects of Cardiac Resynchronization Therapy on Ventricular Electrical Remodeling in Patients With Heart Failure

Towards a Personalized and Dynamic CRT-D

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