Background: Atrioventricular (AV) delay could affect AV and ventricular synchrony in cardiac resynchronization therapy (CRT). Strategies to optimize AV delay according to optimal AV synchrony (AV) or ventricular synchrony (AV) would potentially be discordant. This study aimed to explore a new AV delay optimization algorithm guided by electrograms to obtain the maximum integrative effects of AV and ventricular resynchronization (opt-AV).
Methods: Forty-nine patients with CRT were enrolled. AV was measured through the Ritter method. AV was obtained by yielding the narrowest QRS. The opt-AV was considered to be AV or AV when their difference was < 20 ms, and to be the AV delay with the maximal aortic velocity-time integral between AV and AV when their difference was > 20 ms.
Results: The results showed that sensing/pacing AV (SAV/PAV) were correlated with atrial activation time (P/P) (P < 0.05). Sensing/pacing AV (SAV/PAV) was correlated with the intrinsic AV conduction time (As-Vs/Ap-Vs) (P < 0.01). The percentages of patients with more than 20 ms differences between SAV/PAV and SAV/PAV were 62.9% and 57.1%, respectively. Among them, opt-AV was linearly correlated with SAV/PAV and SAV/PAV The sensing opt-AV (opt-SAV) = 0.1 × SAV + 0.4 × SAV + 70 ms (R = 0.665, P < 0.01) and the pacing opt-AV (opt-PAV) = 0.25 × PAV + 0.5 × PAV + 30 ms (R = 0.560, P < 0.01).
Conclusion: The SAV/PAV and SAV/PAV were correlated with the atrial activation time and the intrinsic AV conduction interval respectively. Almost half of the patients had a > 20 ms difference between SAV/PAV and SAV/PAV. The opt-AV could be estimated based on electrogram parameters.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193898 | PMC |
| http://dx.doi.org/10.1186/s12872-021-02096-1 | DOI Listing |
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