Heart failure & cardiomyopathies
Electrical dyssynchrony mapping and optimization of nonresponders in patients programmed with the adaptive cardiac resynchronization therapy algorithm
Authors' conclusion
Electrical synchrony improves 56% with CRT using aCRT programming and 92% with EDM optimization. Optimization of aCRT-programmed nonresponders results in significant improvements in LV size and systolic function, offering the possibility of converting CRT nonresponders into responders.
Study context
- Population
- Patients programmed with the adaptive cardiac resynchronization therapy (CRT) algorithm
- Participants
- 125 patients
- Exposure
- Electrical dyssynchrony mapping (EDM)-optimized settings vs baseline aCRT settings
- Outcome
- Electrical synchrony quantified as cardiac resynchronization index (CRI), normalized to native rhythm
Main finding
As reported in the abstract
CRI
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Group 1 (LV-only aCRT) | Group 2 (biventricular aCRT) | P value |
|---|---|---|---|
| Baseline CRI, LV-only aCRT (group 1, n=68) vs biventricular aCRT (group 2, n=57) | 62% (SD 25%) | 48% (SD 31%) | P = 0.014 |
| Optimal CRI with sequential biventricular and LV-only pacing vs baseline aCRT, by group | |||
| Sequential biventricular | 92%±13% | 93%±9% | |
| LV-only | 92%±6% | 91%±7% |
- Optimal cardiac resynchronization index (CRI) with sequential biventricular and left ventricle (LV)-only pacing vs baseline aCRT, by group — Optimal CRI significantly higher than baseline aCRT in both groups
- P<.001
Change after EDM optimization in nonresponders (n=53)
- CRI
- 37%±25%; P<.0001
- LVEF
- 6.2%±6.6%; P<.0001
- End-diastolic volume
- 9.5±28.2 mL; P=.015
- End-systolic volume
- 13.4±24.9 mL; P<.001
- Transverse strain
- 1.5%±4.4%; P=.014
- Longitudinal strain
- 1.0%±2.5%; P=.003
- Circumferential strain
- 2.6%±8.5%; P=.047
- Subset of 53 nonresponders
Original publication
Electrical dyssynchrony mapping and optimization of nonresponders in patients programmed with the adaptive cardiac resynchronization therapy algorithm. Heart Rhythm. Published 13 December 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →