TY  - CHAP
U1  - Konferenzveröffentlichung
A1  - Heinke, Matthias
A1  - Ismer, Bruno
A1  - Kühnert, Helmut
A1  - Solbrig, Olaf
A1  - Surber, Ralf
A1  - Haltenberger, Anna
A1  - Querengässer, Jürgen
A1  - Prochnau, Dirk
A1  - Figulla, Hans Reiner
T1  - Improvement of impedance cardiographic cardiac output and acceleration index in atrioventricular and interventricular delay optimized biventricular pacing.
T2  - Biomedical Engineering / Biomedizinische Technik
N2  - Introduction: Cardiac resynchronisation therapy (CRT) with atrioventricular (AV) and interventricular (VV) optimized biventricular pacing (BV) is an established therapy for heart failure (HF) patients with electrical interventricular conduction delay (IVCD). The aim of the study was to compare AV and VV delay optimization with cardiac output (CO) and acceleration index (ACI) impedance cardiographic (ICG) methods. 
Methods: HF patients with IVCD 86.8 ± 33 ms (n=15, age 66 ± 10 years; 2 females, 13 males), New York Heart Association (NYHA) functional class 3.1 ± 0.4, left ventricular (LV) ejection fraction 21.3 ± 7.8 % and QRS duration 176.1 ± 31.7 ms underwent AV and VV delay optimization with CO and ACI methods (Cardioscreen, Medis GmbH, Ilmenau, Germany). After evaluation of optimal AV delay, we evaluated optimal VV delay during simultaneous LV and right ventricular (RV) pacing (LV=RV), LV before RV pacing (LV-RV) and RV before LV pacing (RV-LV). 
Results: Optimal VV delay was -12.3 ± 25.9 ms LV-RV pacing with VV delay range from -80 ms LV-RV pacing to +20 ms RV-LV pacing and RV=LV pacing. Optimal AV delay after atrial sensing was 108.6 ± 20.3 ms (n=14) and optimal AV delay after atrial pacing 190 ± 14.1 ms (n=2) with AV delay range from 80 ms to 200 ms. RV versus BV pacing mode resulted in improvement of CO from 3.4 ± 1.2 l/min to 4.4 ± 1.4 l/min (p<0.001) and ACI from 0.667 ± 0.227 1/s² to 0.834 ± 0.282 1/s² (p<0.002). During 34 ± 26 month BV pacing, the NYHA class improved from 3.1 ± 0.4 to 2.1 ± 0.4 (p<0.001). 
Conclusion: AV and VV delay optimized BV pacing acutely improve ICG CO and ACI and their NYHA class during long-term follow-up. ICG may be a simple and useful technique to optimize AV and VV delay in CRT.
Y1  - 2011
SN  - 0013-5585 (Print)
SS  - 0013-5585 (Print)
SN  - 1862-278X (Online)
SS  - 1862-278X (Online)
U6  - https://doi.org/10.1515/BMT.2011.856
DO  - https://doi.org/10.1515/BMT.2011.856
VL  - 56
IS  - S1
SP  - 7
S1  - 1
PB  - Walter de Gruyter
CY  - Berlin, Boston
ER  -