Effects of AV Delay and VV Delay on Left Atrial Pressure and Waveform in Ambulant Heart Failure Patients: Insights into CRT Optimization

摘要: Background We hypothesized that left atrial pressure (LAP) obtained by a permanent implantable sensor is sensitive to changes in cardiac resynchronization therapy (CRT) settings and could guide CRT optimization improve the response rate. We investigated effect of on LAP its waveform parameters ambulant heart failure (HF) patients. Methods CRT was performed eight HF patients, using echocardiography as reference. acquired at each atrioventricular (AV) intervals five inter-ventricular (VV) intervals. Selected were also evaluated for their sensitivity agreement with echocardiography-guided optimal settings. Results Optimal AV VV varied considerably between patients. All patients exhibited significant morphology optimization. Optimal delay determined from ranged 140 ms 225 ms. Mean tended be lower setting 14 ± 3 mmHg compared shorter ( 160 ms) (P = 0.16). There clear trends smaller peak a-wave 0.11) gentler positive a-slope 0.15) v-slope 0.09) longer delays. negative v-wave slope correlated well echo-guided setting, r = 0.91 0.001) 0.79 0.03), respectively. No effects or seen during optimization. Conclusions LAP good LAP. provide an objective (Clinical Trial Registry information: URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00632372)