Related Experiment Video
Updated: May 13, 2026

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
Discordant left and right ventricular optimal atrioventricular and interventricular delays during biventricular
Salima Qamruddin1, Reza Rafie, Tasneem Z Naqvi
1Cardiac Non Invasive Diagnostic Services, Echocardiography Laboratories, Cardiovascular and Thoracic Institute, Keck University Hospital and Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Abstract:
Echocardiography-guided optimization of atrioventricular (AV) delay (AVD) improves left ventricular (LV) filling, and optimized interventricular delay (VVD) leads to further improvement in cardiac output in patients with biventricular (Biv) pacing. Investigators use LV filling and ejection to optimize AV and VV delay in patients with Biv pacing. Effect of such optimization on right-sided hemodynamics remains unknown. In our experience, few patients experience worsening of right ventricle (RV) hemodynamics when LV parameters are optimized. We present a series of cases where we observed suboptimal RV filling or ejection at optimal AVD and VVD for LV. This RV-LV discordance may contribute to nonresponder rate to cardiac resynchronization therapy (CRT) and should be evaluated in a consecutive series of CRT nonresponder patients to help improve CRT response.
Related Concept Videos
Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Mitral Regurgitation III: Medical Management
Cardiomyopathy V: Interprofessional Care
Mitral Regurgitation I: Introduction
Cardiomyopathy II: Dilated Cardiomyopathy
Mitral Stenosis III: Medical Management

