Pressure-Volume Analysis Demonstrates Short- and Long-Term Hemodynamic Effects of Atrioventricular Interval Modulation Therapy in Hypertension
Authors' conclusion
AVIM therapy acutely reduces SBP by decreasing preload and effective arterial elastance unrelated to lead location without affecting LV end-systolic or end-diastolic function. Chronic AVIM therapy reduces SBP and end-diastolic volume indicative of favorable reverse LV remodeling.
Study context
- Population
- Hypertensive patients with pacemakers and intact atrioventricular (AV) conductionchronic subgroup n = 32
- Participants
- 16 patients
- Comparison
- Atrioventricular interval modulation (AVIM) therapy vs no AVIM
- Outcome
- Acute effects of AVIM therapy
Methodological detailsinvasive pressure-volume analysis, noninvasive pressure-volume analysis
- Invasive pressure-volume analysis
- Noninvasive pressure-volume analysis
Main finding
As reported in the abstract
- Right ventricular pacing (RVp)
- change in end-diastolic volume −12.6 ± 14.0 mL; P = 0.003
- Left bundle branch area pacing (LBBAp)
- change in end-diastolic volume −18.6 ± 16.2 mL; P < 0.001
- RVp
- change in effective arterial elastance −0.23 ± 0.39 mm Hg/mL; P = 0.032
- LBBAp
- change in effective arterial elastance −0.31 ± 0.55 mm Hg/mL; P = 0.037
- RVp
- change in SBP −17.1 ± 10.1 mm Hg; P < 0.001
- LBBAp
- change in SBP −19.2 ± 12.6 mm Hg; P < 0.001
Further findings
Chronic effects of AVIM therapy by noninvasive pressure-volume (PV) analysis (MODERATO II subgroup, n = 32)
- Change in SBP
- −11.7 ± 21.8 mm Hg; P = 0.023
- Change in end-diastolic volume vs control, indicative of reverse remodeling
- −21.5 ± 19.2 mL; P = 0.005
Original publication
Pressure-Volume Analysis Demonstrates Short- and Long-Term Hemodynamic Effects of Atrioventricular Interval Modulation Therapy in Hypertension. JACC Clin Electrophysiol. Published 13 August 2025. doi:10.
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