Improving haemodynamic optimization of cardiac resynchronization therapy for heart failure

Objective : Optimization of cardiac resynchronization therapy using non-invasive haemodynamic parameters produces reliable optima when performed at high atrial paced heart rates. Here we investigate whether this is a result of increased heart rate or atrial pacing itself. Approach : Forty-three patients with cardiac resynchronization therapy underwent haemodynamic optimization of atrioventricular (AV) delay using non-invasive beat-to-beat systolic blood pressure in three states: rest (atrial-sensing, 66   ±  11 bpm), slow atrial pacing (73  ±  12 bpm), and fast atrial pacing (94   ±  10 bpm). A 20-patient subset underwent a fourth optimization, during exercise (80  ±  11 bpm). Main results : Intraclass correlation coefficient (ICC, quantifying information content mean   ±SE) was 0.20  ±  0.02 for resting sensed optimization, 0.45  ±  0.03 for slow atrial pacing ( p    
Source: Physiological Measurement - Category: Physiology Authors: Source Type: research