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Improvement of impedance cardiographic cardiac output and acceleration index in atrioventricular and interventricular delay optimized biventricular pacing.

  • 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) impedanceIntroduction: 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.show moreshow less

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Metadaten
Document Type:Conference Proceeding
Conference Type:Konferenz-Abstract
Zitierlink: https://opus.hs-offenburg.de/754
Bibliografische Angaben
Title (English):Improvement of impedance cardiographic cardiac output and acceleration index in atrioventricular and interventricular delay optimized biventricular pacing.
Conference:BMT 2011: Conference of the German Society for Biomedical Engineering / DGBMT Jahrestagung (45. : 27.-30. September 2011 : Freiburg, Deutschland)
Author:Matthias HeinkeStaff MemberORCiDGND, Bruno IsmerStaff MemberGND, Helmut Kühnert, Olaf Solbrig, Ralf Surber, Anna Haltenberger, Jürgen Querengässer, Dirk Prochnau, Hans Reiner Figulla
Year of Publication:2011
Place of publication:Berlin, Boston
Publisher:Walter de Gruyter
Page Number:1
First Page:7
Parent Title (Multiple languages):Biomedical Engineering / Biomedizinische Technik
Volume:56
Issue:S1
ISSN:0013-5585 (Print)
ISSN:1862-278X (Online)
DOI:https://doi.org/10.1515/BMT.2011.856
Language:English
Inhaltliche Informationen
Institutes:Fakultät Elektrotechnik und Informationstechnik (E+I) (bis 03/2019)
Institutes:Bibliografie
Formale Angaben
Open Access: Closed Access 
Licence (German):License LogoUrheberrechtlich geschützt