Novel Device-Based Algorithm Provides Optimal Hemodynamics During Exercise in Patients With Cardiac Resynchronization Therapy

Kasagawa, Akira; Nakajima, Ikutaro; Izumo, Masaki; Nakayama, Yui; Yamada, Marika; Takano, Makoto; Matsuda, Hisao; Furukawa, Toshiyuki; Miyazaki, Hidekazu; Harada, Tomoo; Akashi, Yoshihiro J.

doi:10.1253/circj.cj-19-0512

Cited by 3 publications

(1 citation statement)

References 25 publications

(17 reference statements)

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“…Fixed differential AVDs as provided by some device manufacturers are far from being physiological in nature. Thus, modern pulse producers should provide a free programmability of wide range AV delays [12] .…”

Section: Discussionmentioning

confidence: 99%

Value of Optimizing Atrioventricular Delay in Patients with Dual Chamber Pacemakers Assessed by Three-Dimensional Echocardiography

Hassan

Bashandy

Kholif

et al. 2022

International Journal of Medical Arts

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Article informationBackground: Cardiac pacing witnessed many advances in the last years, with favorable outcome of saving more lives in different heart diseases associated with conduction abnormalities. Devices usually programmed by manufacturers. However, it did not provide optimal pacing and manual programming was advised. The aim of work:This study aimed to assess the value of manual optimization of atrioventricular delay [AVD] in dual chamber pacemaker [DDD] patients in comparison of default AVD, using three-dimensional Echocardiography. Patients and Methods: Fourty patients with DDD were included. They received pacemaker due to high grade of atrioventricular [AV] block. All were submitted full history taking, general and cardiac clinical examination in a systematic pattern. All were subjected to resting 12-leads electrocardio-graphy, and the pacemaker position was confirmed by chest X ray. Dual-chamber pacemakers were interrogated and programmed using St. Jude Medical, Inc. programmer. All patients were checked after 6 weeks and outcome was compared to original values. Results: Patient's age ranged between 29 and 66 years, and 27 [67.5%] were males. Complete heart block was the principal indication for initial pacing [87.5%] followed by Mobitz type II heart block [12.5%]. Three-dimensional echocardiography revealed that, manual pacing was associated with significant increase of end-systolic volume, end-diastolic volume, ejection fraction and velocity time integral [224.0 ±87, 93.0±34.8, 63.9±3.84 and 63.9±3.84 vs. 187.0±80.6, 75.8±19.4, 60.1±3.09 and 29.2 + 12.7, respectively]. Symptom's improvement revealed that, 21 [77.7%] patients who presented with dyspnea, 15 [83.3%] in dizziness and 20 [90.5%] in the palpitation. Conclusion:It is recommended to use AVD optimization for all patients of DDD pacemakers. This may be associated with long-term benefit mainly for the systolic functions. Echocardiography is the gold standard of timing optimization through mitral flow Doppler as its waves could mark for atrial contraction which is used for AV timing optimization.

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Section: Discussionmentioning

confidence: 99%

Value of Optimizing Atrioventricular Delay in Patients with Dual Chamber Pacemakers Assessed by Three-Dimensional Echocardiography

Hassan

Bashandy

Kholif

et al. 2022

International Journal of Medical Arts

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Effect of adaptive cardiac resynchronization therapy in heart failure patients with pacemaker dependency

Nakamura,

Ishibashi,

Ueda

et al. 2024

J Interv Card Electrophysiol

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Overview of Current Strategies Aiming at Improving Response to Cardiac Resynchronization Therapy

Yamantürk¹,

Candemir²,

Baskovski³

et al. 2022

Anatolian J Cardiol

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Cardiac resynchronization therapy is a treatment modality developed in the early 2000s that targets the mechanical and electrical dyssynchrony in heart failure with reduced ejection fraction patients. Appropriate patient selection conditions specified in the guidelines include measurement of left ventricular systolic dysfunction, QRS width, and assessment of functional classification. Despite consistent and increasing evidence supporting the use of cardiac resynchronization therapy in eligible patients, proportion of patients with the device is still not at the desired level. In addition, studies conducted in recent years have shown that the cardiac resynchronization therapy response of patients is quite heterogeneous and in echocardiographic follow-up, it was observed that reverse remodeling was not at the supposed level in approximately one-third of the patients. In order to change this result, which is due to many reasons, solutions such as using assistive imaging methods, providing optimal patient selection, trying different pacing techniques and post-procedural programming strategies (AV-delay and VV-delay optimization) have been the subject of debate. In this article, we aim to review the mechanisms that have been revealed regarding the differences in cardiac resynchronization therapy response and new pacing techniques—especially conduction system pacing—that may be preferred to resolve poor cardiac resynchronization therapy response.

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Novel Device-Based Algorithm Provides Optimal Hemodynamics During Exercise in Patients With Cardiac Resynchronization Therapy

Cited by 3 publications

References 25 publications

Value of Optimizing Atrioventricular Delay in Patients with Dual Chamber Pacemakers Assessed by Three-Dimensional Echocardiography

Value of Optimizing Atrioventricular Delay in Patients with Dual Chamber Pacemakers Assessed by Three-Dimensional Echocardiography

Effect of adaptive cardiac resynchronization therapy in heart failure patients with pacemaker dependency

Overview of Current Strategies Aiming at Improving Response to Cardiac Resynchronization Therapy

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