Cardiac Resynchronization Therapy and AV Optimization: A Hemodynamic Evaluation with Non-Invasive Techniques
Year: 2025
Type: article
Abstract: Aim: This study aimed to evaluate the impact of atrioventricular (AV) optimization of biventricular pacemakers on cardiac hemodynamic parameters, particularly mitral inflow and aortic valve velocity-time integral (VTI), using impedance cardiography (ICG) and echocardiography in patients with symptomatic systolic heart failure and left bundle branch block unresponsive to cardiac resynchronization therapy. Material and Methods: The study included 20 patients, 10 (50%) males and 10 (50%) females, aged between 18 and 80 years, who had undergone biventricular pacemaker implantation and did not have aortic stenosis, decompensated heart failure, or echocardiographically optimized AV interval measurements. Hemodynamic values were calculated following ICG measurements. Results: The mean AV delay time did not change after AV optimization (p=0.685). However, optimization led to a statistically significant increase in mitral inflow VTI and aortic valve VTI (both p<0.001). No significant post-optimization variations were observed in hemodynamic parameters obtained by ICG compared to baseline measurements. There was a statistically significant decrease in heart rate when compared to the pre-optimization values (p=0.003). Conclusion: This study identified a significant enhancement in echocardiographic parameters attributable to AV optimization. The results obtained with AV optimization were consistent with those of large-scale randomized studies. However, further comprehensive studies are needed to assess the individual patient responses and long-term outcomes.
Source: Düzce Tıp Fakültesi Dergisi
Institution: Mersin Üniversitesi
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414736643