Comparison of Echocardiographic and Electrocardiographic Mapping for Cardiac Resynchronisation Therapy Optimisation
Joint Authors
Pereira, Helder
Jackson, Tom A.
Claridge, Simon
Behar, Jonathan M.
Yao, Cheng
Sieniewicz, Benjamin
Gould, Justin
Porter, Bradley
Sidhu, Baldeep
Gill, Jaswinder
Niederer, Steven
Rinaldi, Christopher A.
Source
Cardiology Research and Practice
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-02-21
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Study hypothesis.
We sought to investigate the association between echocardiographic optimisation and ventricular activation time in cardiac resynchronisation therapy (CRT) patients, obtained through the use of electrocardiographic mapping (ECM).
We hypothesised that echocardiographic optimisation of the pacing delay between the atrial and ventricular leads—atrioventricular delay (AVD)—and the delay between ventricular leads—interventricular pacing interval (VVD)—would correlate with reductions in ventricular activation time.
Background.
Optimisation of AVD and VVD may improve CRT patient outcome.
Optimal delays are currently set based on echocardiographic indices; however, acute studies have found that reductions in bulk ventricular activation time correlate with improvements in acute haemodynamic performance.
Materials and methods.
Twenty-one patients with established CRT criteria were recruited.
After implantation, patients underwent echo-guided optimisation of the AVD and VVD.
During this procedure, the participants also underwent noninvasive ECM.
ECM maps were constructed for each AVD and VVD.
ECM maps were analysed offline.
Total ventricular activation time (TVaT) and a ventricular activation time index (VaT10-90) were calculated to identify the optimal AVD and VVD timings that gave the minimal TVaT and VaT10-90 values.
We correlated cardiac output with these electrical timings.
Results.
Echocardiographic programming optimisation was not associated with the greatest reductions in biventricular activation time (VaT10-90 and TVaT).
Instead, bulk activation times were reduced by a further 20% when optimised with ECM.
A significant inverse correlation was identified between reductions in bulk ventricular activation time and improvements in LVOT VTI (p<0.001), suggesting that improved ventricular haemodynamics are a sequelae of more rapid ventricular activation.
Conclusions.
EAM-guided programming optimisation may achieve superior fusion of activation wave fronts leading to improvements in CRT response.
American Psychological Association (APA)
Pereira, Helder& Jackson, Tom A.& Claridge, Simon& Behar, Jonathan M.& Yao, Cheng& Sieniewicz, Benjamin…[et al.]. 2019. Comparison of Echocardiographic and Electrocardiographic Mapping for Cardiac Resynchronisation Therapy Optimisation. Cardiology Research and Practice،Vol. 2019, no. 2019, pp.1-9.
https://search.emarefa.net/detail/BIM-1145973
Modern Language Association (MLA)
Pereira, Helder…[et al.]. Comparison of Echocardiographic and Electrocardiographic Mapping for Cardiac Resynchronisation Therapy Optimisation. Cardiology Research and Practice No. 2019 (2019), pp.1-9.
https://search.emarefa.net/detail/BIM-1145973
American Medical Association (AMA)
Pereira, Helder& Jackson, Tom A.& Claridge, Simon& Behar, Jonathan M.& Yao, Cheng& Sieniewicz, Benjamin…[et al.]. Comparison of Echocardiographic and Electrocardiographic Mapping for Cardiac Resynchronisation Therapy Optimisation. Cardiology Research and Practice. 2019. Vol. 2019, no. 2019, pp.1-9.
https://search.emarefa.net/detail/BIM-1145973
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1145973