A real-time three-dimensional echocardiographic validation of an intracardiac electrogram-based method for optimizing cardiac resynchronization therapy.

A real-time three-dimensional echocardiographic validation of an intracardiac electrogram-based method for optimizing cardiac resynchronization therapy. Research Abstract Details 

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A real-time three-dimensional echocardiographic validation of an intracardiac electrogram-based method for optimizing cardiac resynchronization therapy. Abstract Text:

Maria Cristina Porciani,Carmelo Massimiliano Rao,Matteo Mochi,Francesco Cappelli,Gabriella Bongiorno,Alessandro Paoletti Perini,Alessio Lilli,Giuseppe Ricciardi,Lawrence Hashtroudi,Paolo Silvestri,S Serge Barold,Luigi Padeletti,

Introduction: Although optimization of atrioventricular and interventricular delays has been demonstrated to improve hemodynamics in patients with cardiac resynchronization therapy (CRT), the required time-consuming procedure discourages its use in clinical practice. Recently, a new method for CRT optimization based on the intracardiac electrogram (IEGM) detected by the implanted leads, has been developed. We evaluated the effectiveness of this method in improving left ventricular (LV) asynchrony and performance using real-time 3D echocardiography (RT3DE). Methods and Results: Twenty patients with CRT were prospectively studied. RT3DE was performed before and after IEGM optimization. The standard deviation of the time to the regional LV minimum systolic volume (Tmsv) for all 16 segments (Tmsv 16-SD), six basal and six mid segments (Tmsv 12-SD), and the six basal segments (Tmsv 6-SD) were assessed as a asynchrony indexes. LV end-diastolic and end-systolic volumes (EDV, ESV), stroke volume (SV), ejection fraction (EF), myocardial performance index (MPI), ejection time (ET), and filling time (FT), corrected by R-R interval, were also evaluated. After IEGM optimization, as compared with baseline Tmsv 12-SD and Tmsv 16-SD decreased (P = 0.01, P< 0.001, respectively), EF and SV improved (P < 0.001, P = 0.01 respectively), FT/RR and ET/RR increased (P = 0.02 for both), and MPI improved (P < 0.001). Tmsv 6-SD, EDV and ESV did not change. Conclusion: A simple IEGM-based method of CRT optimization decreased LV dyssynchrony and improved systolic function.

A real-time three-dimensional echocardiographic validation of an intracardiac electrogram-based method for optimizing cardiac resynchronization therapy. Publishing Authors By Initials

MC Porciani,CM Rao,M Mochi,F Cappelli,G Bongiorno,AP Perini,A Lilli,G Ricciardi,L Hashtroudi,P Silvestri,SS Barold,L Padeletti,

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A real-time three-dimensional echocardiographic validation of an intracardiac electrogram-based method for optimizing cardiac resynchronization therapy. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Pacing and clinical electrophysiology : PACE

VOLUME: 31

Page Numbers: 56-63

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ISSN: 0147-8389

DAY: 9

MONTH: Jan

YEAR: 2008

A real-time three-dimensional echocardiographic validation of an intracardiac electrogram-based method for optimizing cardiac resynchronization therapy. Information

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LANGUAGE: eng

NlmUniqueID: 7803944

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AFFILIATION: Clinica Medica Careggi, Florence, Italy.

Country: United States

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MEDLINETA: Pacing Clin Electrophysiol

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