PMID- 24164640
OWN - NLM
STAT- MEDLINE
DCOM- 20141118
LR  - 20220311
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 37
IP  - 3
DP  - 2014 Mar
TI  - Three-dimensional echocardiographic optimization improves outcome in cardiac 
      resynchronization therapy compared to ECG optimization: a randomized comparison.
PG  - 312-20
LID - 10.1111/pace.12281 [doi]
AB  - AIMS: There is little consensus on optimal atrioventricular (AV) and 
      ventricular-to-ventricular (VV) intervals in cardiac resynchronization therapy 
      (CRT). The aim of this study was to examine a novel combination of Doppler 
      echocardiography (DE) and three-dimensional echocardiography (3DE) for 
      individualized AV- and VV-interval optimization compared to conventional 
      electrocardiogram (ECG) optimization. METHODS: In this double-blind, randomized 
      controlled trial, 77 patients (male: 57, age: 68 +/- 10 years) with severely 
      reduced ejection fraction (EF), New York Heart Association (NYHA) class III or 
      IV, and wide QRS complex (>120 ms) have been included. Patients were randomized 
      to either AV- and VV-interval optimization using DE and 3DE (group 1, n = 39) or 
      ECG (group 2, n = 38). 3DE was performed in all patients for the evaluation of 
      left ventricular (LV) dimensions, EF and systolic dyssynchrony index (SDI), and 
      NYHA class obtained before CRT and after 3 months. Primary endpoint of the study 
      was clinical response to CRT, defined as a reduction of NYHA class by >/=1 score. 
      Secondary endpoints were change of EF, LV volumes, and SDI. RESULTS: There were 
      significantly more responders in group 1 (82%) than in group 2 (58%, P = 0.021). 
      Similarly, group 1 showed a larger increase in EF (7.0 +/- 6.0% vs 3.4 +/- 5.6%, P = 
      0.015) and a more pronounced reduction of SDI (-4.5 +/- 5.9% vs -1.5 +/- 5.6%, P = 
      0.039) than group 2. CONCLUSION: Compared with conventional ECG optimization, 
      this novel echocardiographic optimization protocol resulted in a significantly 
      higher response rate, improved LV systolic function, and may be used to select 
      the optimal AV and VV intervals in CRT.
CI  - (c)2013, The Authors. Journal compilation (c)2013 Wiley Periodicals, Inc.
FAU - Sonne, Carolin
AU  - Sonne C
AD  - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, 
      Technische Universitat Munchen, Munich, Germany.
FAU - Bott-Flugel, Lorenz
AU  - Bott-Flugel L
FAU - Hauck, Simon
AU  - Hauck S
FAU - Hadamitzky, Martin
AU  - Hadamitzky M
FAU - Lesevic, Hasema
AU  - Lesevic H
FAU - Demetz, Gabriele
AU  - Demetz G
FAU - Braun, Daniel
AU  - Braun D
FAU - Wolf, Petra
AU  - Wolf P
FAU - Hausleiter, Jorg
AU  - Hausleiter J
FAU - Schomig, Albert
AU  - Schomig A
FAU - Kolb, Christof
AU  - Kolb C
LA  - eng
SI  - DRKS/00004454
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20131025
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Double-Blind Method
MH  - Echocardiography, Doppler/*methods
MH  - Echocardiography, Three-Dimensional/*methods
MH  - Electrocardiography/*methods
MH  - Female
MH  - Heart Failure/*diagnosis/*prevention & control
MH  - Humans
MH  - Male
MH  - Prognosis
MH  - Treatment Outcome
OTO - NOTNLM
OT  - 3D echocardiography
OT  - cardiac resynchronization therapy
OT  - dyssynchrony
OT  - optimization
EDAT- 2013/10/30 06:00
MHDA- 2014/11/19 06:00
CRDT- 2013/10/30 06:00
PHST- 2013/05/08 00:00 [received]
PHST- 2013/07/06 00:00 [revised]
PHST- 2013/08/12 00:00 [accepted]
PHST- 2013/10/30 06:00 [entrez]
PHST- 2013/10/30 06:00 [pubmed]
PHST- 2014/11/19 06:00 [medline]
AID - 10.1111/pace.12281 [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2014 Mar;37(3):312-20. doi: 10.1111/pace.12281. Epub 
      2013 Oct 25.