PMID- 15851220
OWN - NLM
STAT- MEDLINE
DCOM- 20050628
LR  - 20161222
IS  - 1547-5271 (Print)
IS  - 1547-5271 (Linking)
VI  - 1
IP  - 5
DP  - 2004 Nov
TI  - Randomized prospective trial of atrioventricular delay programming for cardiac 
      resynchronization therapy.
PG  - 562-7
AB  - OBJECTIVES: The purpose of this study was to determine if AV delay optimization 
      with continuous-wave Doppler aortic velocity-time integral (VTI) is clinically 
      superior to an empiric program in patients treated with cardiac resynchronization 
      therapy (CRT) for severe heart failure. BACKGROUND: The impact of AV delay 
      programming on clinical outcomes associated with CRT is unknown. METHODS: A 
      randomized, prospective, single-blind clinical trial was performed to compare two 
      methods of AV delay programming in 40 patients with severe heart failure referred 
      for CRT. Patients were randomized to either an optimized AV delay determined by 
      Doppler echocardiography (group 1, n = 20) or an empiric AV delay of 120 ms 
      (group 2, n = 20) with both groups programmed in the atriosynchronous 
      biventricular pacing (VDD) mode. Optimal AV delay was defined as the AV delay 
      that yielded the largest aortic VTI at one of eight tested AV intervals (between 
      60 and 200 ms). New York Heart Association (NYHA) functional classification and 
      quality-of-life (QOL) score were compared 3 months after randomization. RESULTS: 
      Immediately after CRT initiation with AV delay programming, VTI improved by 4.0 
      +/- 1.7 cm vs 1.8 +/- 3.6 cm (P < .02), and ejection fraction (EF) increased by 
      7.8 +/- 6.2% vs 3.4 +/- 4.4% (P < .02) in group 1 vs group 2, respectively. After 
      3 months, NYHA classification improved by 1.0 +/- 0.5 vs 0.4 +/- 0.6 class points 
      (P < .01), and QOL score improved by 23 +/- 13 versus 13 +/- 11 points (P < .03) 
      for group 1 vs group 2, respectively. CONCLUSIONS: Echocardiography-guided AV 
      delay optimization using the aortic Doppler VTI improves clinical outcomes at 3 
      months compared to an empiric AV delay program of 120 ms.
FAU - Sawhney, Navinder S
AU  - Sawhney NS
AD  - Cardiovascular Division, Washington University, School of Medicine, St. Louis, 
      Missouri 63110, USA.
FAU - Waggoner, Alan D
AU  - Waggoner AD
FAU - Garhwal, Sanjeev
AU  - Garhwal S
FAU - Chawla, Mohit K
AU  - Chawla MK
FAU - Osborn, Judy
AU  - Osborn J
FAU - Faddis, Mitchell N
AU  - Faddis MN
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
MH  - Atrioventricular Node/diagnostic imaging/*physiology
MH  - Cardiac Pacing, Artificial/*methods
MH  - Defibrillators, Implantable/statistics & numerical data
MH  - Echocardiography, Doppler
MH  - Female
MH  - Heart Failure/classification/*therapy
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Quality of Life
MH  - Single-Blind Method
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
EDAT- 2005/04/27 09:00
MHDA- 2005/06/29 09:00
CRDT- 2005/04/27 09:00
PHST- 2004/04/22 00:00 [received]
PHST- 2004/07/02 00:00 [accepted]
PHST- 2005/04/27 09:00 [pubmed]
PHST- 2005/06/29 09:00 [medline]
PHST- 2005/04/27 09:00 [entrez]
AID - S1547-5271(04)00393-5 [pii]
AID - 10.1016/j.hrthm.2004.07.006 [doi]
PST - ppublish
SO  - Heart Rhythm. 2004 Nov;1(5):562-7. doi: 10.1016/j.hrthm.2004.07.006.