Comparison of echocardiography and device based algorithm for atrio-ventricular delay optimization in heart block patients

作     者：Rajesh Vijayvergiya Ankur Gupta 

作者机构：Department of CardiologyAdvanced Cardiac CentrePost Graduate Institute of Medical Education and Research 

出 版 物：《World Journal of Cardiology》 (世界心脏病学杂志（英文版）（电子版）)

年 卷 期：2015年第7卷第11期

页      面：801-807页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 1002[医学-临床医学] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Atrio-ventricular delay optimization Complete hear 

摘      要：AIM: To compare the atrio-ventricular(AV/PV) delay optimization by echocardiography and intra-cardiac electrocardiogram(IEGM) based Quick Opt algorithm in complete heart block(CHB) patients, implanted with a dual chamber pacemaker. METHODS: We prospectively enrolled 20 patients(age 59.45 ± 18.1 years; male: 65%) with CHB, who were implanted with a dual chamber pacemaker. The left ventricular outflow tract velocity time-integral was measured after AV/PV delay optimization by both echocardiography and Quick Opt algorithm method. Bland-Altman analysis was used for agreement between the two techniques. RESULTS: The optimal AV and PV delay determined by echocardiography was 155.5 ± 14.68 ms and 122.5 ± 17.73 ms(P 0.0001), respectively and by Quick Opt method was 167.5 ± 16.73 and 117.5 ms ± 9.10 ms(P 0.0001), respectively. A good agreement was observed between optimal AV and PV delay as measured by two methods. However, the correlation of the optimal AV(r = 0.0689, P = 0.77) and PV(r = 0.2689, P = 0.25) intervals measured by the two techniques was poor. The time required for AV/PV optimization was 45.26 ± 1.73 min by echocardiography and 0.44 ± 0.08 min by Quick Opt method(P 0.0001).CONCLUSION: The programmer based IEGM method is an automated, quick, easier and reliable alternative to echocardiography for the optimization of AV/PV delay in CHB patients, implanted with a dual chamber pacemaker.