通过心脏电生理学的非侵入性成像来优化CRT的SyncAV®算法的可视化:NICE-CRT试验
Philipp Spitaler1, Bernhard Erich Pfeifer2,3, Agnes Mayr4
1Department of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, Austria.
使用SyncAV算法在心脏再同步治疗 (CRT) 中优化心房间间间间,可以缩短QRS持续时间. 程序员应该考虑30或50毫秒作为默认设置,以改善心力衰竭患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 医疗器械 医疗器械
背景情况:
- 心脏再同步治疗 (CRT) 设备可以通过定期AV间隔优化来改善结果.
- 基于设备的AV间隔优化算法的常规临床应用仍然是一个挑战.
研究的目的:
- 评估SyncAV算法的有效性,以优化CRT患者心房 (AV) 间隔.
- 为了确定最佳的设备编程设置,以尽量减少心室激活时间.
主要方法:
- 在14名患有LBBB的心力衰竭患者中使用了非侵入性心脏电生理学成像.
- 测试了不同的SyncAV算法设置,以找到最短的心室激活时间.
- 患者的PR间隔≤250毫秒,并接受CRT装置.
主要成果:
- 编程SyncAV算法以30或50毫秒的偏移显著减少了平均QRS持续时间 (p=0.01).
- 40毫秒的偏移也减少了QRS持续时间,但没有达到统计学意义 (p=0.08).
- 最佳的偏移设置允许在每256次节拍后动态调整AV间隔.
结论:
- 该NICE-CRT研究支持默认的SyncAV偏移50毫秒对于接受CRT的LBBB患者具有保存的AV导电.
- 另一个30毫秒的默认偏移也可能是合适的.
- 建议使用心电图谱技术进行个性化编程,用于非最佳CRT反应的患者.
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