© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.
CP18: ONE YEAR EXPERIENCE WITH AUTOMATIC AV DELAY OPTIMIZATION BY PEAK ENDOCARDIAL ACCELERATION
Sorin Biomedica CRM Saluggia, Italy
BACKGROUND: Optimization of paced AV Delay is important for maximal ventricular performance. Today's practice is based on an echographic procedure, seldom performed due to follow-up time constraints. Optimal AV Delay (OAVD) estimation by Peak Endocardial Acceleration (PEA) may be performed via an automatic AV Delay Scanning followed by a programmer-based analysis of PEA data.
AIM: to retrospectively review effectiveness and ease of use of the OAVD estimation functionality.
METHODS: Data were collected between 12/2003 and 11/2004 on 106 patients implanted with Sorin Biomedica Living System (pts., 62M, age 65.5±9.5y, 25 centres). OAVD estimation was performed at discharge and during follow-up (FU) at 1 month. (7 pts lost at FU). Pacers were programmed in DDD (n=66) and VDD (n=40). On 33 pts the function was executed during an effort test (submaximal 5 min cycling, at or over 110 bpm heart rate). Echo evaluation of OAVD was performed on 62 cases at discharge (30.0%), none at FU.
RESULTS: OAVD was estimated in 223/238 cases (93.7%). Duration of the procedure was 101.7±35.3 s (min 64, max 188). OAVD by PEA was 137.3±31.8 ms in DDD and 122.4±36.2 ms in VDD at discharge. OAVD by echo was 143.3±39.1 ms and 129.1±44.2 ms respectively (p=ns). Correlation between PEA and echo measurements was r=0.92, p>0.001. At FU OAVD by PEA was 143.2±33.4 ms in DDD and 126.7±34.4 ms in VDD. OAVD estimation during effort was possible in 31/33 cases. All of these pts were in VDD mode. OAVD was 104.1±53.2 ms.
CONCLUSION: the function allowed easy and reliable optimization of AVD in a short time. The function may improve patient management and monitoring without extra time and cost to the follow-up. OAVD estimation during effort may be a further addition to standard patient evaluation.