Long-term follow-up of atrioventricular delay optimization in patients with biventricular pacing
Noriko Inoue, Toshiyuki Ishikawa, Shinichi Sumita, Takeshi Nakagawa, Tsukasa Kobayashi, Kohei Matsushita, Katsumi Matsumoto, Yasuo Ohkusu, Minoru Taima, Masami Kosuge, Kazuaki Uchino, Kazuo Kimura, Satoshi Umemura, Noriko Inoue, Toshiyuki Ishikawa, Shinichi Sumita, Takeshi Nakagawa, Tsukasa Kobayashi, Kohei Matsushita, Katsumi Matsumoto, Yasuo Ohkusu, Minoru Taima, Masami Kosuge, Kazuaki Uchino, Kazuo Kimura, Satoshi Umemura
Abstract
Background: Atrioventricular (AV) delay optimization may be important in patients with biventricular pacing and the optimal AV delay can be predicted using Doppler echocardiography and the formula: optimal AV delay = AV delay-the interval between the end of A wave and complete closure of the mitral valve when the AV delay is set at slightly prolonged AV delay.
Methods and results: In the present study the efficacy of this method was evaluated in 5 patients (67.4+/-8.0 (SD) years old) with biventricular pacing. Cardiac output (CO) and diastolic filling time were measured by Doppler echocardiography. When the AV delay was set at the predicted optimal AV delay -25 ms, the predicted optimal AV delay (133+/-66 ms) and predicted optimal AV delay + 25 ms, the respective CO were 4.5+/-0.9, 5.3+/-1.0, 4.8+/-1.0 L/min (p<0.05, ANOVA) and the diastolic filling times were 364 +/-100, 373+/-105, 335+/-84 ms (p<0.05, ANOVA). Congestive heart failure improved from New York Heart Association class 3.6+/-0.5 to 1.4+/-0.5 (p<0.001).
Conclusions: AV delay optimization is important in patients with biventricular pacing and can be easily achieved by the new method.
Source: PubMed