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Tailored echocardiographic interventricular delay programming further optimizes left ventricular performance after

Marc Vanderheyden¹, Tine De Backer, Maximo Rivero-Ayerza

¹Cardiovascular Center, Onze Lieve Vrouw Ziekenhuis, Aalst, Belgium. marc.vanderheyden@olvz-aalst.be

|September 29, 2005

Summary

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Optimizing the timing of left ventricular (LV) and right ventricular (RV) stimulation in cardiac resynchronization therapy significantly improves heart function. Tailoring the LV-RV delay enhances stroke volume and reduces delays in patients with advanced heart failure.

Area of Science:

Cardiology
Biomedical Engineering

Background:

Cardiac resynchronization therapy (CRT) aims to correct left ventricular (LV) dyssynchrony.
Optimal timing for LV and right ventricular (RV) stimulation in CRT is not well understood.

Purpose of the Study:

To evaluate the acute hemodynamic effects of biventricular pacing with varying interventricular delays in advanced heart failure patients.

Main Methods:

Twenty patients with advanced heart failure underwent biventricular device implantation with sequential RV and LV timing capabilities.
Echocardiographic parameters, including LV outflow tract velocity-time integral and filling times, were measured under various pacing conditions.
Interventricular delays were adjusted by advancing LV or RV stimuli up to 60 ms.

Main Results:

Related Experiment Videos

Optimized sequential biventricular pacing significantly increased the velocity-time integral and LV filling time compared to simultaneous pacing.
Sequential pacing also significantly decreased interventricular and intraventricular delays.
The optimal pacing interval was not predictable by clinical or echocardiographic factors.

Conclusions:

Optimizing interventricular timing in CRT prolongs LV filling time, reduces asynchrony, and increases stroke volume.
Further improvement in LV hemodynamics is achievable in advanced heart failure patients by optimizing LV-RV delay during CRT.