CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Association of Coronary Anatomical Complexity With Clinical Outcomes After Percutaneous or Surgical Revascularization in the Veterans Affairs Clinical Assessment Reporting and Tracking Program Large-Bore Radial Access for Complex PCI: A Flash of COLOR With Some Shades of Grey Prevalence, Presentation and Treatment of 'Balloon Undilatable' Chronic Total Occlusions: Insights from a Multicenter US Registry Invasive Coronary Physiology After Stent Implantation: Another Step Toward Precision Medicine Hemodynamic Response to Nitroprusside in Patients With Low-Gradient Severe Aortic Stenosis and Preserved Ejection Fraction COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up The Prognostic Value of Exercise Echocardiography After Percutaneous Coronary Intervention Discharge Against Medical Advice After Percutaneous Coronary Intervention in the United States Basic Biology of Oxidative Stress and the Cardiovascular System: Part 1 of a 3-Part Series 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
|<<... 44 45 46 47 48 49 50 ...>>|

Clinical Trial2018 Mar;11(3):e005912.

JOURNAL：Circ Arrhythm Electrophysiol. Article Link

Can We Use the Intrinsic Left Ventricular Delay (QLV) to Optimize the Pacing Configuration for Cardiac Resynchronization Therapy With a Quadripolar Left Ventricular Lead?

van Everdingen WM, Zweerink A, Cramer MJ et al. Keywords: cardiac resynchronization therapy; heart failure; hemodynamics; humans; stroke volume

ABSTRACT

BACKGROUND - Previous studies indicated the importance of the intrinsic left ventricular (LV) electric delay (QLV) for optimal benefit to cardiac resynchronization therapy. We investigated the use of QLV for achieving optimal acute hemodynamic response to cardiac resynchronization therapy with a quadripolar LV lead.


METHODS AND RESULTS - Forty-eight heart failure patients with a left bundle branch block were prospectively enrolled (31 men; age, 66±10 years; LV ejection fraction, 28±8%; QRS duration, 176±14 ms). Immediately after cardiac resynchronization therapy implantation, invasive LV pressure-volume loops were recorded during biventricular pacing with each separate electrode at 4 atrioventricular delays. Acute cardiac resynchronization therapy response, measured as change in stroke work (Δ%SW) compared with intrinsic conduction, was related to intrinsic interval between Q on the ECG and LV sensing delay (QLV), normalized for QRS duration (QLV/QRSd), and electrode position. QLV/QRSd was 84±9% and variation between the 4 electrodes 9±5%. Δ%SW was 89±64% and varied by 39±36% between the electrodes. In univariate analysis, an anterolateral or lateral electrode position and a high QLV/QRSd had a significant association with a large Δ%SW (all P <0.01). In a combined model, only QLV/QRSd remained significantly associated with Δ%SW (P<0.05). However, a direct relation between QLV/QRSd and Δ%SW was only seen in 24 patients, whereas 24 patients showed an inverse relation.

CONCLUSIONS - The large variation in acute hemodynamic response indicates that the choice of the stimulated electrode on a quadripolar lead is important. Although QLV/QRSd was associated with acute hemodynamic response at group level, it cannot be used to select the optimal electrode in the individual patient.

© 2018 American Heart Association, Inc.
>CBS CBS 2019

> CBS 2019

> CBS 2019 注册

> CBS 2019 会议日程

> CBS 2019 学术征集

> CBS 2019 热点

 CBSMD

> CBSMD 网站注册

> 教育中心

> 荐读文献

> Top 10 阅读文献

> 文献导读
CBS 2019 CBS 2019 主席团 教育中心 科研动态
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top