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Title: Long-term variations in optimal programming of cardiac resynchronization therapy devices.
Austin Authors: O'Donnell, D ;Nadurata, V;Hamer, A;Kertes, P;Mohamed, U;Mohammed, W
Affiliation: Department of Electrophysiology Unit, Austin Health, Studley Road, Heidelberg, Victoria, 3084, Australia
Issue Date: 1-Jan-2005
Publication information: Pacing and Clinical Electrophysiology : Pace; 28 Suppl 1(): S24-6
Abstract: The optimal follow-up and long-term programming of cardiac resynchronization therapy (CRT) devices are uncertain. The aim of this study was to quantify the temporal variations in programming parameters to optimize the follow-up of these devices. Before, during, and at specified intervals over 9 months after implant, 40 recipients of CRT devices were studied. At each visit, the patients were tested with a fixed sequence of stimulation parameters during echocardiographic and electrocardiographic (ECG) recordings. The optimal AV delay and inter-ventricular delays (V-V) were determined according to echocardiographic criteria. The echocardiographic data were, in turn, compared with the ECG recordings. Among the 40 patients, the optimal stimulation parameters remained unchanged throughout the follow-up in only three patients. In 18 patients, adjustments were required at each follow-up sessions. There was a trend toward reduction in the left ventricular (LV) predominance of the optimal V-V delay and an increase in the AV delay during follow-up. The mean optimal V-V delay at implant was 22 ms (-12 to +32 ms) with the LV activated first, versus 12 ms (-16 to +32 ms) at 9 months. The mean AV delay at implant was 115 ms versus 137 ms at 9 months. Individual changes could not be accurately predicted. The optimal stimulation parameters for CRT vary over time. Detailed, regular reevaluations, and reprogramming of optimal parameters may be appropriate.
Gov't Doc #: 15683505
DOI: 10.1111/j.1540-8159.2005.00070.x
Journal: Pacing and clinical electrophysiology : PACE
Type: Journal Article
Subjects: Cardiac Pacing, Artificial.methods.standards
Follow-Up Studies
Pacemaker, Artificial.standards
Time Factors
Appears in Collections:Journal articles

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