Initial experiences of maintaining atrioventricular intrinsic conduction during cardiac resynchronization therapy in non-responders.
BACKGROUND
Cardiac resynchronization therapy (CRT) is a major breakthrough in therapy for advanced heart failure patients; however, a number of key clinical research questions remain, perhaps most importantly the issue of why apparently suitable patients do not respond to CRT.


METHODS
Seven patients, six males and one female, aged (56.43 +/- 6.13) years, all diagnosed with dilated cardiomyopathy, were included in this study. They were all non-responders to CRT who underwent routine optimization postoperatively, and received optimal drug therapy. On the basis of biventricular pacing, titrating various atrioventricular (AV) intervals were performed to get the true fusional QRS complexes composed of biventricular pacing and AV intrinsic conduction. Then, the effects of AV intrinsic conduction during CRT were evaluated.


RESULTS
On the setting of AV intrinsic conduction during CRT, the true fusional QRS complexes were the narrowest, and all patients showed alleviation of symptoms, improvement of exercise tolerance, life quality and hemodynamic parameters during more than 6 months of follow-up.


CONCLUSIONS
Titrating AV intervals to get the true fusional QRS complexes composed of biventricular pacing and AV intrinsic conduction will be beneficial for non-responders to CRT. Maintaining AV intrinsic conduction during CRT may decrease the rates of non-responders to CRT.
Wang
Ru-xing
RX
Department of Cardiology, First Affiliated Hospital of Kunming Medical College, Kunming, Yunnan 650032, China.
Guo
Tao
T
Hua
Bao-tong
BT
Han
Ming-hua
MH
Zhao
Ling
L
Yang
Jun
J
Li
Shu-min
SM
Liu
Zhong-mei
ZM
Luo
Zhi-ling
ZL
D054537:Atrioventricular Block / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome