PMID- 17496288
OWN - NLM
STAT- MEDLINE
DCOM- 20080114
LR  - 20161124
IS  - 1099-5129 (Print)
IS  - 1099-5129 (Linking)
VI  - 9
IP  - 9
DP  - 2007 Sep
TI  - Impedance cardiography: a useful and reliable tool in optimization of cardiac 
      resynchronization devices.
PG  - 744-50
AB  - AIMS: Optimizing cardiac resynchronization therapy (CRT) devices has become more 
      complex since modification of both atrioventricular (AV) and interventricular 
      (VV) stimulation intervals has become possible. The current paper presents data 
      from the routine use of impedance cardiography (IC)-based cardiac output (CO) 
      measurements to guide the optimization of AV- and VV-interval timing of CRT 
      devices. METHODS AND RESULTS: Forty-six patients with heart failure (left 
      ventricular ejection fraction <35%, New York Heart Association (NYHA) III-IV) and 
      left bundle branch block (>130 ms) in sinus rhythm were evaluated 3-5 days after 
      implantation of a CRT device by means of IC. CO was measured without pacing and 
      with biventricular pacing using a standard protocol of VV- and AV-interval 
      modification from -60 to +60 ms and 80 to 140 ms, respectively, in 20 ms steps. 
      Mean CO without pacing was 3.66 +/- 0.85 L/min and significantly increased to 
      4.40 +/- 1.1 L/min (P<0.05) with simultaneous biventricular pacing and an AV 
      interval of 120 ms. 'Optimizing' both VV and AV intervals further increased CO to 
      4.86 +/- 1.1 L/min (P<0.05). Maximum CO was measured in most patients with left 
      ventricular pre-excitation. The proportion of 'non-responders' to CRT was reduced 
      by 56% following AV- and VV-interval modification using IC guidance. CONCLUSION: 
      Modification of both AV and VV intervals in patients with a CRT device 
      significantly improves CO compared with standard simultaneous biventricular 
      pacing and no pacing. IC is a useful non-invasive technique for guiding this 
      modification. Marked variability of optimal AV and VV intervals between patients 
      requires optimization of these intervals for each patient individually.
FAU - Heinroth, Konstantin M
AU  - Heinroth KM
AD  - Department of Medicine III/Cardiology, Martin-Luther-University Halle-Wittenberg, 
      E, rnst-Grube-Strasse 40, 06097, Halle (Saale), Germany. 
      konstantin.heinroth@medizin.uni-halle.de
FAU - Elster, Marcel
AU  - Elster M
FAU - Nuding, Sebastian
AU  - Nuding S
FAU - Schlegel, Frithjof
AU  - Schlegel F
FAU - Christoph, Arnd
AU  - Christoph A
FAU - Carter, Justin
AU  - Carter J
FAU - Buerke, Michael
AU  - Buerke M
FAU - Werdan, Karl
AU  - Werdan K
LA  - eng
PT  - Journal Article
DEP - 20070511
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Aged
MH  - Cardiac Output/physiology
MH  - Cardiac Pacing, Artificial/*methods
MH  - Cardiography, Impedance/instrumentation/*methods
MH  - Cardiology/methods
MH  - *Defibrillators, Implantable
MH  - *Echocardiography, Doppler
MH  - Female
MH  - Heart Failure/diagnostic imaging/*therapy
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - *Pacemaker, Artificial
EDAT- 2007/05/15 09:00
MHDA- 2008/01/15 09:00
CRDT- 2007/05/15 09:00
PHST- 2007/05/15 09:00 [pubmed]
PHST- 2008/01/15 09:00 [medline]
PHST- 2007/05/15 09:00 [entrez]
AID - eum086 [pii]
AID - 10.1093/europace/eum086 [doi]
PST - ppublish
SO  - Europace. 2007 Sep;9(9):744-50. doi: 10.1093/europace/eum086. Epub 2007 May 11.