Adaptive Cardiac Resynchronization Therapy Effect on Electrical Dyssynchrony (aCRT-ELSYNC): A randomized controlled
Kazi T Haq1, Nichole M Rogovoy1, Jason A Thomas1,2
1Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.
Heart Rhythm O2
|August 25, 2021
Summary
Adaptive cardiac resynchronization therapy (aCRT) similarly impacts electrical dyssynchrony as conventional CRT. However, aCRT uniquely reduces right ventricular uncoupling, improving interventricular dyssynchrony.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Adaptive cardiac resynchronization therapy (aCRT) offers clinical benefits over conventional CRT, yet underlying mechanisms require elucidation.
- Understanding the impact of aCRT on cardiac electrical dyssynchrony is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the effects of aCRT and conventional CRT on electrical dyssynchrony.
- To investigate changes in ventricular electrical uncoupling (VEU) and electrical dyssynchrony index (EDI) post-therapy.
Main Methods:
- A prospective, double-blind, randomized controlled trial involving 27 patients undergoing CRT.
- Utilized cardiac computed tomography and 128-electrode body surface mapping for noninvasive electrocardiographic imaging.
- Measured changes in VEU (LV vs. RV activation time difference) and EDI (SD of epicardial activation times) at baseline and 6 months.
Main Results:
- Both aCRT and conventional CRT showed no significant difference in overall VEU and EDI changes.
- aCRT demonstrated a significant reduction in VEU (18.9 ms, P=.034), unlike conventional CRT (P=.525).
- Specific findings noted differences in conduction block patterns between typical and atypical left bundle branch block (LBBB).
Conclusions:
- The impact of aCRT and conventional CRT on overall electrical dyssynchrony is comparable.
- aCRT uniquely contributes to harmonizing interventricular dyssynchrony by effectively reducing right ventricular uncoupling.
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