Long-term clinical effects of programmer-guided atrioventricular and interventricular delay optimization: Intracardiac electrography versus echocardiography for cardiac resynchronization therapy in patients with heart failure

J Int Med Res. 2013 Feb;41(1):115-22. doi: 10.1177/0300060512474570. Epub 2013 Jan 23.

Abstract

Objectives: To compare the haemodynamic results and long-term clinical outcomes of intracardiac electrography (QuickOpt®; St Jude Medical, St Paul, MN, USA) and echocardiography for optimization of atrioventricular (AV) and interventricular (VV) delays in cardiac resynchronization therapy (CRT).

Methods: Patients with CRT devices were prospectively enrolled; AV/VV delays were optimized by either QuickOpt® or echocardiography. Patients in the QuickOpt® group underwent both echocardiography and QuickOpt® optimization, and QuickOpt® AV/VV delays were used to program the CRT. All patients were followed-up for 12 months.

Results: In total, 44 patients were enrolled. There was good correlation between AV/VV delays determined by QuickOpt® (n = 20) and echocardiography (n = 24). QuickOpt® was significantly faster than echocardiography-guided optimization. Cardiac function, 6-min walking distance and left ventricular ejection fraction were significantly and similarly improved in both groups at 6 and 12 months compared with baseline. In the QuickOpt® group, left ventricular end diastolic diameters were significantly smaller at 6 and 12 months compared with baseline.

Conclusions: QuickOpt® is a quick, convenient and easy to perform method for optimization of AV and VV delays, with a similar long-term clinical outcome to echocardiography-guided optimization.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac Resynchronization Therapy*
  • Demography
  • Echocardiography*
  • Electrophysiologic Techniques, Cardiac*
  • Female
  • Heart Failure / physiopathology*
  • Heart Failure / therapy*
  • Humans
  • Male
  • Middle Aged
  • Time Factors