Accession Number:

ADA409868

Title:

Optimizing Cardiac Resynchronization Therapy in Heart Failure Patients by Measuring Transient Changes in Sinus Rate During Pacing

Descriptive Note:

Corporate Author:

GUIDANT CORP ST PAUL MN CARDIAC RHYTHMMANAGEMENT/DEPT OF HEART FAILURE RESEARCH

Report Date:

2001-10-25

Pagination or Media Count:

5.0

Abstract:

To optimize cardiac resynchronization therapy CRT for chronic heart failure CHF patients, acute studies show that left ventricular pacing site and atrio-ventricular AV delay can be individualized to maximize aortic pulse pressure PP increase, In the normal patient it is known that atrial cycle length ACL increases as PP increases via the baroreceptor reflex, Therefore, we evaluated another parameter for optimization of pacing parameters - transient ACL, or inversely, sinus heart rate, In a retrospective study, 29 CHF patients, acutely implanted to measure ACL and aortic PP, each received atrial-triggered ventricular pacing in 15 different randomized combinations of 3 pacing sites and 5 AV delays Each trial contained 15 intrinsic beats no pacing and 5 paced beats PP and ACL changes with pacing were averaged over the 5 trials, The pacing combination with maximum ACL increase was hypothesized to be statistically related to maximum PP increase, For patients responding to pacing therapy N 20, the ACL algorithm predicted optimal or near-optimal PP increase 75 of optimal pacing combinations for most of these patients 85 and predicted combinations yielding 50- 75 of optimal for the rest 15, This paper describes an algorithm for optimizing PP response via transient ACL measurements, The ACL algorithm may allow rapid and minimally invasive optimization of pacing site and AV delay for CRT in CHF patients,

Subject Categories:

  • Anatomy and Physiology

Distribution Statement:

APPROVED FOR PUBLIC RELEASE