title: Cardiac resynchronization therapy (CRT) with right ventricular sense triggered left ventricular pacing benefits for the hemodynamics compared with standard CRT for chronic congestive heart failure: A cross-over study.
abstract: BACKGROUND
  The aim of this study was to investigate the effect of cardiac resynchronization therapy (CRT) with right ventricular (RV) sense triggered left ventricular (LV) pacing for chronic heart failure (CHF).
  
  
  METHODS
  Thirty patients who were eligible for the Class I indication of CRT were enrolled and the informed consents were signed. Left ventricular ejection fraction (LVEF), diastolic mitral flow velocity time integral (VTI), mitral regurgitation flow VTI, and aortic valve flow VTI were measured with GE Vivid 7 (GE Medical, Milwaukee, WI, USA) before and after CRT. The echocardiographic measurements and the average annual costs of the device use were compared.
  
  
  RESULTS
  The duration of QRS complex, the length of time used for optimization, and the average annual cost of the device use under RV sense triggered LV pacing were significantly less than that under standard biventricular (BiV) pacing (p < 0.01), while the average battery lifetime was longer. Subgroup analysis showed that LVEF, diastolic mitral flow VTI, and aortic valve flow VTI under RV sense triggered LV pacing were greater than that under standard BiV pacing with right or LV pre-activation. The average battery lifetime was significantly longer and the average annual cost of the device use was less. The mitral regurgitation flow VTI under RV sense triggered LV pacing was less than that under standard BiV pacing with RV pre-activation.
  
  
  CONCLUSIONS
  RV sense triggered LV provides benefits for CHF patients over standard CRT in terms of maintaining the physiological atrio-ventricular delay of atrio-ventricular node and improving the acute hemodynamic effects.
authors.forename: Li-Jin
authors.initials: LJ
authors.lastname: Pu
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.forename: Ling
authors.initials: L
authors.lastname: Zhao
authors.forename: Zhi-Ling
authors.initials: ZL
authors.lastname: Luo
authors.forename: Bao-Tong
authors.initials: BT
authors.lastname: Hua
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Han
authors.forename: Shu-Min
authors.initials: SM
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.forename: Yun-Zhu
authors.initials: YZ
authors.lastname: Peng
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Kunming Medical University. guotaoppppp@hotmail.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Guo
mesh_terms: D001021:Aortic Valve / Q000503:physiopathology; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D058409:Cardiac Resynchronization Therapy Devices; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D018592:Cross-Over Studies; D004562:Electrocardiography; D005260:Female; D017048:Health Care Costs; D006333:Heart Failure / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right