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A prospective comparison of echocardiography and device algorithms for atrioventricular and interventricular interval

Ravindu Kamdar1, Evelyn Frain, Fiona Warburton

  • 1Department of Cardiology, St Bartholomew's Hospital, Barts and the London NHS Trust, Dominion House, 60 Bartholomew Close, West Smithfield, EC1A 7BE London, UK.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|November 7, 2009
PubMed

Insights

Echocardiographic optimization of cardiac resynchronization therapy (CRT) settings showed poor agreement with the QuickOpt algorithm. Echocardiography provided superior hemodynamic outcomes compared to the automated QuickOpt method.

Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Cardiac resynchronization therapy (CRT) optimization of atrioventricular (AV) and interventricular (VV) intervals is crucial but complex.
  • Current echocardiographic optimization is resource-intensive, typically reserved for non-responders.
  • Automated algorithms like QuickOpt aim to simplify this process.

Purpose of the Study:

  • To compare the efficacy of echocardiographic optimization versus the QuickOpt automated algorithm for CRT settings.
  • To assess the agreement and hemodynamic impact of both optimization techniques.

Main Methods:

  • A study involving 26 heart failure patients post-CRT implantation.
  • Optimization of AV and VV intervals performed using both echocardiography and QuickOpt.
  • Left ventricular outflow tract (LVOT) velocity-time integral (VTI) measured to assess hemodynamic performance.

Main Results:

  • Good correlation (R2 = 0.77) was observed between LVOT VTI values from both methods.
  • Poor agreement was found for optimal AV and VV intervals, with significant differences in 15/26 and 10/26 patients, respectively.
  • Echocardiographic optimization resulted in significantly better LVOT VTI in 22/26 patients.

Conclusions:

  • There is a notable lack of agreement between echocardiographic and QuickOpt methods for determining optimal AV and VV intervals.
  • Echocardiographic optimization yields superior hemodynamic outcomes in CRT patients compared to the QuickOpt algorithm.
Abstract

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