Comparison of echocardiography and device based algorithm for atrio-ventricular delay optimization in heart block...

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Devices

Background:

• Complete heart block (CHB) necessitates dual chamber pacemaker implantation.
• Optimizing atrio-ventricular (AV) and pulmonary vein (PV) delays is crucial for pacemaker function.
• Current optimization methods, like echocardiography, can be time-consuming.

Purpose of the Study:

• To compare the efficacy of echocardiography and the intra-cardiac electrocardiogram (IEGM) based QuickOpt algorithm for AV/PV delay optimization.
• To evaluate the time efficiency and reliability of the QuickOpt method in CHB patients.

Main Methods:

• Prospective enrollment of 20 CHB patients with dual chamber pacemakers.
• Measurement of left ventricular outflow tract velocity time-integral using both echocardiography and QuickOpt.
• Bland-Altman analysis to assess agreement between the two optimization techniques.

Main Results:

• Both methods determined optimal AV and PV delays, with QuickOpt showing slightly different values.
• A good agreement was observed between the methods for optimal AV and PV delay.
• The QuickOpt method significantly reduced optimization time (0.44 min) compared to echocardiography (45.26 min).

Conclusions:

• The IEGM-based QuickOpt method is a faster, easier, and reliable alternative for AV/PV delay optimization in CHB patients.
• This automated approach streamlines pacemaker programming.
• Potential for improved patient outcomes through efficient device management.