1. Comparison between IEGM-based approach and echocardiography in AV/PV and VV delay optimization in CRT-D recipients (Quicksept study)
- Author
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Massimo Giammaria, Gianluca Quirino, Enrico Cecchi, Gaetano Senatore, Paolo Pistelli, Mario Bocchiardo, Roberto Mureddu, Paolo Diotallevi, Eraldo Occhetta, Andrea Magnani, Mauro Bensoni, Catia Checchinato, Valentina Conti, Sandra Badolati, Antonio Mazza, Enrico Gostoli, Giuditta Corgnati, Michele Raineri, Marco Giuggia, Marica Di Tria, Giuseppe Trapani, Claudia Amellone, Rosa Coppoletta, Marco Piana, Valeria Sebastiani, Aldo Pinnavia, Giuliana Ronzani, Cristina Piccinino, Antonello Perrucca, Lucio Capulzini, Daniele Barone, Andrea Motto, Cosimo Tolardo, Roberto Orsi, Filippo Rabajoli, Anna Ferraro, Elisa Favro, Maria Teresa Lucciola, Fabrizio Orlando, Davide Forno, Massimo Imazio, Alberto De Salvia, Mohamed Moballeghi, and Monica Anselmino
- Subjects
Cardiac resinchronization therapy ,Optimization algorythm ,IEGM based algorythm ,Mid-septum stimulation ,Echocardiographyc optimization ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: AtrioVentricular (AV) and InterVentricular (VV) delay optimization can improve ventricular function in Cardiac Resynchronization Therapy (CRT) and is usually performed by means of echocardiography. St Jude Medical has developed an automated algorhythm which calculates the optimal AV and VV delays (QuickOpt™) based on Intracardiac ElectroGrams, (IEGM), within 2 min. So far, the efficacy of the algorhythm has been tested acutely with standard lead position at right ventricular (RV) apex. Aim of this project is to evaluate the algorhythm performance in the mid- and long-term with RV lead located in mid-septum. Methods: AV and VV delays optimization data were collected in 13 centers using both echocardiographic and QuickOpt™ guidance in CRTD implanted patients provided with this algorhythm. Measurements of the aortic Velocity Time Integral (aVTI) were performed with both methods in a random order at pre-discharge, 6-month and 12-month follow-up. Results: Fifty-three patients were studied (46 males; age 68 ± 10y; EF 28 ± 7%). Maximum aVTI obtained by echocardiography at different AV delays, were compared with aVTI acquired at AV delays suggested by QuickOpt. The AV Pearson correlations were 0.96 at pre-discharge, 0.95 and 0,98 at 6- and 12- month follow-up respectively. After programming optimal AV, the same approach was used to compare echocardiographic aVTI with aVTI corresponding to the VV values provided by QuickOpt. The VV Pearson Correlation were 0,92 at pre-discharge, 0,88 and 0.90 at 6-month and 12- month follow-up respectively. Conclusions: IEGM-based optimization provides comparable results with echocardiographic method (maximum aVTI) used as reference with mid-septum RV lead location.
- Published
- 2016
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