@inproceedings{RotterRoeschHeinkeetal.2011, author = {Kirsten-Maria Rotter and Lena R{\"o}sch and Matthias Heinke and Frank Kleimenhagen and Frank Weber and Ralf Peters and Christoph A. Nienaber and Bruno Ismer}, title = {Programmer feature to quantify interventricular desynchronization and interatrial conduction intervals}, series = {Biomedical Engineering / Biomedizinische Technik}, volume = {56}, number = {S1}, publisher = {Walter de Gruyter}, address = {Berlin, Boston}, issn = {0013-5585 (Print)}, doi = {10.1515/bmt.2011.850}, pages = {7}, year = {2011}, abstract = {Introduction: Patient selection for cardiac resynchronization therapy (CRT) requires quantification of left ventricular conduction delay (LVCD). After implantation of biventricular pacing systems, individual AV delay (AVD) programming is essential to ensure hemodynamic response. To exclude adverse effects, AVD should exceed individual implant-related interatrial conduction times (IACT). As result of a pilot study, we proposed the development of a programmer-based transoesophageal left heart electrogram (LHE) recording to simplify both, LVCD and IACT measurement. This feature was implemented into the Biotronik ICS3000 programmer simultaneously with 3-channel surface ECG. Methods: A 5F oesophageal electrode was perorally applied in 44 heart failure CRT-D patients (34m, 10f, 65±8 yrs., QRS=162±21ms). In position of maximum left ventricular deflection, oesophageal LVCD was measured between onsets of QRS in surface ECG and oesophageal left ventricular deflection. Then, in position of maximum left atrial deflection (LA), IACT in VDD operation (As-LA) was calculated by difference between programmed AV delay and the measured interval from onset of left atrial deflection to ventricular stimulus in the oesophageal electrogram. IACT in DDD operation (Ap-LA) was measured between atrial stimulus and LA.. Results: LVCD of the CRT patients was characterized by a minimum of 47ms with mean of 69±23ms. As-LA and Ap-LA were found to be 41±23ms and 125±25ms, resp., at mean. In 7 patients (15,9\%), IACT measurement in DDD operation uncovered adverse AVD if left in factory settings. In this cases, Ap-LA exceeded the factory AVD. In 6 patients (13,6\%), IACT in VDD operation was less than or equal 10ms indicating the need for short AVD. Conclusion: Response to CRT requires distinct LVCD and AVD optimization. The ICS3000 oesophageal LHE feature can be utilized to measure LVCD in order to justify selection for CRT. IACT measurement simplifies AV delay optimization in patients with CRT systems irrespective of their make and model.}, language = {en} }