Improvement of LV Reverse Remodeling Using Dynamic Programming of Fusion-Optimized Atrioventricular Intervals in Cardiac Resynchronization Therapy.
Improvement of LV Reverse Remodeling Using Dynamic Programming of Fusion-Optimized Atrioventricular Intervals in Cardiac Resynchronization Therapy.
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在心脏再同步治疗中使用融合优化房室间隔的动态编程改进左室逆重构
DOI：
10.3389/fcvm.2021.700424
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发表时间：
2021
影响因子：
3.6
通讯作者：
Zhao X
中科院分区：
文献类型：
--
作者：
Wang Z;Li P;Zhang B;Huang J;Chen S;Cai Z;Qin Y;Fan J;Tang W;Qin Y;Li R;Zhao X
背景：为患者量身定制的SyncAV算法缩短了QRS持续时间（QRSd），超出了传统双心室（BiV）起搏的范围。然而，缺乏SyncAV改善心脏起搏治疗（CRT）反应能力的证据。本研究旨在评价SyncAV增强CRT对超声心动图和临床反应的影响。方法和结果：来自三个中心的使用四极CRT系统（Abbott）治疗的连续性心力衰竭（HF）患者入组。共122例患者根据是否接受了带或不带SyncAV的CRT分为BiV+SyncAV组（n = 68）和BiV组（n = 54）。在基线和随访期间评估心电图、超声心动图和临床数据。CRT的超声心动图反应定义为左心室收缩末期容积（LVESV）降低≥15%，临床反应定义为NYHA分级降低≥1。6个月随访时，BiV+SyncAV组的基线QRSd和LVESV下降幅度大于BiV组（QRSd −36.25 ± 16.33 vs. −22.72 ± 18.75 ms，P < 0.001; LVESV −54.19 ± 38.87 vs. −25.37 ± 36.48 ml，P < 0.001）。与BiV组相比，BiV+SyncAV组中更多患者被分类为超声心动图（82.35 vs. 64.81%; P = 0.036）和临床应答者（83.82 vs. 66.67%; P = 0.033）。随访期间，未发生因HF恶化或严重手术相关并发症导致的死亡。结论：与BiV起搏相比，BiV联合SyncAV可更显著地降低QRSd，并改善接受CRT治疗的HF患者的LV重构和长期结局。
Background: The patient-tailored SyncAV algorithm shortens the QRS duration (QRSd) beyond what conventional biventricular (BiV) pacing can. However, evidence of the ability of SyncAV to improve the cardiac resynchronization therapy (CRT) response is lacking. The aim of this study was to evaluate the impact of CRT enhanced by SyncAV on echocardiographic and clinical responses. Methods and Results: Consecutive heart failure (HF) patients from three centers treated with a quadripolar CRT system (Abbott) were enrolled. The total of 122 patients were divided into BiV+SyncAV (n = 68) and BiV groups (n = 54) according to whether they underwent CRT with or without SyncAV. Electrocardiographic, echocardiographic, and clinical data were assessed at baseline and during follow-up. Echocardiographic response to CRT was defined as a ≥15% decrease in left ventricular end-systolic volume (LVESV), and clinical response was defined as a NYHA class reduction of ≥1. At the 6-month follow-up, the baseline QRSd and LVESV decreased more significantly in the BiV+SyncAV than in the BiV group (QRSd −36.25 ± 16.33 vs. −22.72 ± 18.75 ms, P < 0.001; LVESV −54.19 ± 38.87 vs. −25.37 ± 36.48 ml, P < 0.001). Compared to the BiV group, more patients in the BiV+SyncAV group were classified as echocardiographic (82.35 vs. 64.81%; P = 0.036) and clinical responders (83.82 vs. 66.67%; P = 0.033). During follow-up, no deaths due to HF deterioration or severe procedure related complications occurred. Conclusion: Compared to BiV pacing, BiV combined with SyncAV leads to a more significant reduction in QRSd and improves LV remodeling and long-term outcomes in HF patients treated with CRT.
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影响因子：
4.8
作者：
Abraham, William T.;Gras, Daniel;Gupta, Manish S.
通讯作者：
Gupta, Manish S.
影响因子：
158.5
作者：
Cleland, JGF;Daubert, J;Khan, NK
通讯作者：
Khan, NK
影响因子：
158.5
作者：
Moss, Arthur J.;Hall, W. Jackson;Zareba, Wojciech
通讯作者：
Zareba, Wojciech
影响因子：
2.7
作者：
Arbelo, Elena;Maria Tolosana, Jose;Mont, Lluis
通讯作者：
Mont, Lluis
影响因子：
7
作者：
Trucco, Emilce;Maria Tolosana, Jose;Mont, Lluis
通讯作者：
Mont, Lluis