Is CRT Optimization Obsolete? A Referral Center’s Experience

Bibliographic Details
Title: Is CRT Optimization Obsolete? A Referral Center’s Experience
Authors: Shmaila Saleem-Talib, Mirjam D. Duineveld, Jurjan C. Schipper, Arnaud D. Hauer, Hemanth Ramanna, Natasja M.S. de Groot, Michael G. Scheffer
Source: Reviews in Cardiovascular Medicine, Vol 25, Iss 2, p 63 (2024)
Publisher Information: IMR Press, 2024.
Publication Year: 2024
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: crt-optimization, cardiac resynchronization therapy, strain rate imaging, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: Background: Cardiac resynchronization therapy (CRT) is a well-established therapy for patients with heart failure (HF). However, 30% of HF patients do not show any improvement in clinical status after CRT implantation. In this study, we report our echocardiography-based CRT optimization methodology, in daily practice at our CRT referral center. Methods: We included 350 ambulatory patients, who were referred to our center for optimization after CRT implantation. A protocol-driven echocardiographic approach for adjusting mechanical dyssynchrony, whereby adjusting for ventriculoventricular (VV) delays with strain and atrioventricular (AV) delays with Doppler echocardiography was performed. We defined changes in left ventricular ejection fraction (LVEF) and New York Heart Association (NYHA) classes as outcome variables in the evaluation of the CRT outcomes. Results: Optimization was obtained in 288 (82%) patients. VV and AV timings were adjusted to 61% and 51%, respectively. In 3%, biventricular pacing was turned off and in 3% left ventricular (LV) only pacing was programmed. The LVEF and NYHA class showed significant improvements in all patients who underwent CRT optimization. Conclusions: CRT optimization remains valuable in improving LVEF and functional status measured using the NYHA class in all patients receiving CRT devices.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1530-6550
Relation: https://www.imrpress.com/journal/RCM/25/2/10.31083/j.rcm2502063; https://doaj.org/toc/1530-6550
DOI: 10.31083/j.rcm2502063
Access URL: https://doaj.org/article/7191328d1efc481c923adc64bf0bb779
Accession Number: edsdoj.7191328d1efc481c923adc64bf0bb779
Database: Directory of Open Access Journals
More Details
ISSN:15306550
DOI:10.31083/j.rcm2502063
Published in:Reviews in Cardiovascular Medicine
Language:English