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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2004-1-14
pubmed:abstractText
The optimization of atrioventricular (AV) delay is known to significantly contribute to maximum cardiac performance. The aim of this study was to validate a new, fast, and simple echocardiographic method of identifying the AV delay that provides the maximum cardiac output (CO). Right heart catheterization and Doppler echocardiography of transmitral filling were performed simultaneously in 18 patients with heart failure and at least minimum functional mitral regurgitation treated with atrial synchronized biventricular pacing. CO derived from catheterization and Doppler filling parameters were measured at the predicted optimal AV delay (oAVD), the short AV delay (oAVD - 50 ms), and the long AV delay (oAVD + 28 ms on average/range, +10 ms to +50 ms) during a constant heart rate. The AV delay was regarded as optimal if the end of atrial contraction (represented by the end of A wave of transmitral filling) coincided with the beginning of ventricular contraction (heralded by the onset of the systolic component of mitral regurgitation). Prediction of the optimal AV delay included the following steps: (1) The maximum AV delay at which full ventricular capture is still preserved was found under electrocardiographic control. (2) This value, decreased by 5 to 10 ms, was designated as "the testing long AV delay," and the time interval from the end of the A wave to the onset of the systolic component of mitral regurgitation (time t1) was measured at this setting. (3) oAVD was simply calculated as "the testing long AV delay"- time t1. The CO measured at the oAVD (4.5 +/- 0.7 1. min-1) significantly exceeded those at the short AV delay (4.3 +/- 0.7 1. min-1, P < 0.01) and the long AV delay (4.4 +/- 0.8 1. min-1, P < 0.01), respectively. The method correctly determined the maximum CO in 78% of the patients. In conclusion, Doppler echocardiography enables very rapid and accurate optimization of AV synchrony in patients after the implantation of a biventricular pacemaker.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0147-8389
pubmed:author
pubmed:issnType
Print
pubmed:volume
27
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
58-64
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed:year
2004
pubmed:articleTitle
A fast and simple echocardiographic method of determination of the optimal atrioventricular delay in patients after biventricular stimulation.
pubmed:affiliation
First Department of Internal Medicine, St. Anna Hospital, Masaryk University, Brno, Czech Republic. jaroslav.meluzin@fnusa.cz
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't