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Updated: Sep 9, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

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Clinical and echocardiographic outcomes of sync-atrioventricular versus nominal optimization in correlation with QRS

Gamela Nasr1, Aliaa Tarek Mahfouz2,3, Mostafa Wanees Ahmed El Husseny4,5

  • 1Department of Cardiology, Faculty of medicine, Suez Canal university, Ismailia, Egypt.

BMC Cardiovascular Disorders
|August 28, 2025
PubMed

Insights

The novel SyncAV algorithm significantly reduced QRS duration in patients receiving cardiac resynchronization therapy (CRT), improving clinical and echocardiographic outcomes. This device-based approach optimizes biventricular pacing for better heart failure management.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) is crucial for heart failure (HF) with reduced ejection fraction.
  • Optimizing atrioventricular (AV) delay in CRT improves patient response.
  • Novel algorithms aim to enhance CRT's effectiveness through automatic timing optimization.

Purpose of the Study:

  • To evaluate the efficacy of the SyncAV algorithm for optimizing biventricular (BiV) pacing.
  • To assess if SyncAV improves cardiac synchrony and acute hemodynamic response compared to nominal settings.
  • To investigate the impact of SyncAV on QRS duration and clinical outcomes in CRT patients.

Main Methods:

  • 36 patients with left bundle branch block undergoing CRT implantation were studied.
  • Two pacing modes were compared: Nominal AV delay and SyncAV algorithm.
  • Electrocardiographic and echocardiographic data were collected at 1 and 6 months post-implantation.

Main Results:

  • SyncAV significantly reduced QRS duration compared to nominal settings (P < 0.001).
  • Improvements in clinical and echocardiographic parameters were observed with SyncAV.
  • No QRS duration prolongation occurred in any patient using the SyncAV algorithm.

Conclusions:

  • Patient-tailored BiV pacing using the SyncAV algorithm facilitates post-implant electrical optimization.
  • The automatic device-based algorithm effectively adjusts to intrinsic atrioventricular timing.
  • SyncAV offers a promising approach for enhancing CRT outcomes in selected LBBB patients.
Abstract

Keywords:
Biventricular pacingCardiac resynchronization therapyCardiomyopathyHeart failureMechanical remodelingQRS duration

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