title: Optimization of cardiac resynchronization therapy: echocardiographic vs semiautomatic device algorithms.
abstract: Large evidence supports the importance of individualized optimization of cardiac resynchronization therapy in patients with congestive heart failure. The aim of this study was to compare a recently developed intracardiac electrogram (IEGM)-based method with the Doppler echocardiographic (ECHO)-based method to calculate optimal atrioventricular (AV) and interventricular (VV) delays. Ten male patients implanted with a St Jude Medical resynchronization device received AV and VV delay assessment with both the IEGM and the ECHO-based methods. Estimates of the optimal AV and VV delays assessed by the 2 tested methods proved highly comparable. No difference emerged between the IEGM (126.8+/-22.7) and the ECHO (127.3+/-19.8) AV delay values (P=.987). The VV delay suggested by ECHO was highly significantly correlated with the delays calculated by the IEGM method (35+/-27.6 vs 21.31+/-24.31; r(2)=0.78; P<.001). These preliminary data support the evidence that an IEGM based cardiac resynchronization optimization method may be as reliable as a complete ECHO assessment.
authors.affiliation: Department of Internal Medicine, Cardiology Unit, San Giovanni Battista, Molinette Hospital, University of Turin, Italy. matt.ans@alice.it
authors.forename: Matteo
authors.initials: M
authors.lastname: Anselmino
authors.forename: Marina
authors.initials: M
authors.lastname: Antolini
authors.forename: Claudia
authors.initials: C
authors.lastname: Amellone
authors.forename: Elena
authors.initials: E
authors.lastname: Piovano
authors.forename: Riccardo
authors.initials: R
authors.lastname: Massa
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Trevi
mesh_terms: D000368:Aged; D000465:Algorithms; D002304:Cardiac Pacing, Artificial; D018619:Echocardiography, Doppler, Pulsed; D004562:Electrocardiography; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013318:Stroke Volume; D016277:Ventricular Function, Left