ISSN: 2451-0629
Archives of Medical Science - Atherosclerotic Diseases
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Official journal of the International Lipid Expert Panel (ILEP)
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1/2020
vol. 5
 
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abstract:
Clinical research

Pacing at accelerated heart rate during echocardiography-guided atrioventricular optimisation following cardiac resynchronisation therapy

Daniel M. Spevack
1, 2
,
Amala Chirumamilla
1
,
Wilbert S. Aronow
2

1.
Division of Cardiology, Department of Medicine, Montefiore Medical Centre and Albert Einstein College of Medicine, Bronx, New York, USA
2.
Department of Cardiology, Westchester Medical Centre and New York Medical College, Valhalla, New York, USA
Arch Med Sci Atheroscler Dis 2020; 5: e230–e236
Online publish date: 2020/09/10
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Introduction
Although echo-guided atrioventricular optimisation (AVO) is standardly performed at rest, this approach may not provide optimal AV synchrony during daily activities.

Material and methods
The AVO protocol at one of two hospital campuses had been modified to be performed while pacing at an accelerated heart rate. We tested if this approach would improve the yield from AVO compared to the other campus, where AVO was performed at the intrinsic sinus rate.

Results
Between campuses, no significant differences were seen in demographics, chamber sizes, left ventricular ejection fraction, and diastolic function grade. Those having AVO at C2 were more likely to demonstrate “fusion prone” physiology (36% vs. 9%; p = 0.006) and were more likely to display either “truncation- or fusion-prone” physiology (58% vs. 27%; p = 0.007).

Conclusions
When AVO was performed at an accelerated heart rate, patients with “truncation-prone” or “fusion-prone” physiology were identified more readily.

keywords:

pacing, atrioventricular optimisation, echocardiography, cardiac resynchronisation therapy

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