Evaluation of the Optimized Algorithm for Interventricular Intervals in Biventricular Pacing Therapy_West China Medical Journal

Authors：

LIU Hanxiong , DENG Xiaoqi , CAI Lin , LI Jin , TONG Lin ,  DENG Juelin.

Department of Cardiology, the Third People’s Hospital of Chengdu·the Second Affilicated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan 610031, P. R. China;

Corresponding author：

DENG Juelin., Email: lhanx@126.com

Keywords：

双心室起搏; 室间间期; 优化算法

DOI：

10.7507/1002-0179.20130435

Video：

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目的　提出双心室起搏室间间期（VV）优化新算法，并验证其合理性。方法　选择2009年6月－2012年12月间在成都市第三人民医院心内科住院的慢性心力衰竭并接受双心室起搏是心脏再同步化治疗的患者41例，根据心脏电－机械耦联的原理，将体表心电图和超声指标的数量关系用新公式来表述，通过前瞻性自身对照研究来比较新算法与传统方法的差异。结果　41例患者均分别采用新算法、传统超声法及腔内心电图法进行VV优化，测主动脉血流速度时间积分（AVTI）并统计耗时。经方差分析显示新算法的AVTI[（22.32 ± 3.48） cm]优于传统腔内心电图法的AVTI[（19.22 ± 3.07）cm]，组间差异有统计学意义（P＜0.05）；而新算法的耗时[（18.80 ± 3.30）min]较传统超声法的耗时[（203.81 ± 20.12）min]明显减少，组间差异有统计学意义（P＜0.01）。结论　新算法用于双心室起搏是心脏再同步化治疗的VV优化准确、快速，具有合理性及临床推广价值。

Citation： LIU Hanxiong,DENG Xiaoqi,CAI Lin,LI Jin,TONG Lin,DENG Juelin.. Evaluation of the Optimized Algorithm for Interventricular Intervals in Biventricular Pacing Therapy. West China Medical Journal, 2013, 28(9): 1380-1383. doi: 10.7507/1002-0179.20130435 Copy

1.	Hua W, Wang DM, Cai L, et al. A prospective study to evaluate the efficacy of an intracardiac electrogram-based atrioventricular and interventricular intervals optimization method in cardiac resynchronization therapy[J]. Chin Med J, 2012, 125(3): 428-433.
2.	孙欣, 王浩, 江勇, 等. 应用超声心动图指导心脏再同步化治疗的室间间期优化[J].中华医学超声杂志(电子版), 2012, 9(2): 23-26.
3.	Lecoq G, Leclercq C, Leray E, et al. Clinical and electrocardiographic predictors of a positive response to cardiac resynchronization therapy in advanced heart failure[J]. Eur Heart J, 2005, 26(11): 1094-1100.
4.	Ritter P, Padeletti L, Gillio-Meina L, et al. Determination of the optimal atrioventricular delay in DDD pacing. Comparison between echo and peak endocardial acceleration measurements[J]. Europace, 2001, 1(2): 126-130.
5.	Jansen AH, Bracke FA, van Dantzig JM, et al. Correlation of echo Doppler optimization of atrioventricular delay in cardiac resynchronization therapy with invasive hemodynamics in patients with heart failure secondary to ischemic or idiopathic dilated cardiomyopathy[J]. Am J Cardiol, 2006, 97(4): 552-557.
6.	Sogaard P, Egeblad H, Pedersen AK, et al. Sequential versus simultaneous biventricular resynchronization for severe heart failure: evaluation by tissue Doppler imaging[J]. Circulation, 2002, 106(16): 2078-2084.
7.	van Gelder BM, Meijer A, Bracke FA. The optimized V-V interval determined by interventricular conduction times versus invasive measurement by LVdP/dTMAX[J]. J Cardiovasc Electrophysiol, 2008,19(9): 939-944.
8.	杨立波, 贾绍斌, 张华. 一键优化心脏再同步化治疗慢性心力衰竭的疗效观察[J]. 临床心血管病杂志, 2011, 27(4): 271-274.
9.	Min X, Meine M, Baker JH, et al. Estimation of the optimal VV delay by an IEGM-based method in cardiac resynchronization therapy[J]. Pacing Clin Electrophysiol, 2007, 30(Suppl 1): S19-S22.
10.	Kerlan JE, Sawney NS, Waggoner AD, et al. Prospective comparison of optimization methods for cardiac resynchronization therapy[J]. Heart Rhythm, 2006, 3(2): 148-154.
11.	Kohl P, Bollensdorff C, Garny A. Effects of mechanosensitive ion channels on ventricular electrophysiology: experimental and theoretical models[J]. Exp Physiol, 2006, 91(2): 307-321.
12.	Baker JH, McKenzie J, Beau S, et al. Acute evaluation of programmer-guided AV/PV and VV delay optimization comparing an IEGM method and echocardiogram for cardiac resynchronization therapy in heart failure patients and dual-chamber ICD implants[J]. J Cardiovasc Electrophysiol, 2007, 18(2): 185-191.

1. 　Hua W, Wang DM, Cai L, et al. A prospective study to evaluate the efficacy of an intracardiac electrogram-based atrioventricular and interventricular intervals optimization method in cardiac resynchronization therapy[J]. Chin Med J, 2012, 125(3): 428-433.
2. 　孙欣, 王浩, 江勇, 等. 应用超声心动图指导心脏再同步化治疗的室间间期优化[J].中华医学超声杂志(电子版), 2012, 9(2): 23-26.
3. 　Lecoq G, Leclercq C, Leray E, et al. Clinical and electrocardiographic predictors of a positive response to cardiac resynchronization therapy in advanced heart failure[J]. Eur Heart J, 2005, 26(11): 1094-1100.
4. 　Ritter P, Padeletti L, Gillio-Meina L, et al. Determination of the optimal atrioventricular delay in DDD pacing. Comparison between echo and peak endocardial acceleration measurements[J]. Europace, 2001, 1(2): 126-130.
5. 　Jansen AH, Bracke FA, van Dantzig JM, et al. Correlation of echo Doppler optimization of atrioventricular delay in cardiac resynchronization therapy with invasive hemodynamics in patients with heart failure secondary to ischemic or idiopathic dilated cardiomyopathy[J]. Am J Cardiol, 2006, 97(4): 552-557.
6. 　Sogaard P, Egeblad H, Pedersen AK, et al. Sequential versus simultaneous biventricular resynchronization for severe heart failure: evaluation by tissue Doppler imaging[J]. Circulation, 2002, 106(16): 2078-2084.
7. 　van Gelder BM, Meijer A, Bracke FA. The optimized V-V interval determined by interventricular conduction times versus invasive measurement by LVdP/dTMAX[J]. J Cardiovasc Electrophysiol, 2008,19(9): 939-944.
8. 　杨立波, 贾绍斌, 张华. 一键优化心脏再同步化治疗慢性心力衰竭的疗效观察[J]. 临床心血管病杂志, 2011, 27(4): 271-274.
9. 　Min X, Meine M, Baker JH, et al. Estimation of the optimal VV delay by an IEGM-based method in cardiac resynchronization therapy[J]. Pacing Clin Electrophysiol, 2007, 30(Suppl 1): S19-S22.
10. 　Kerlan JE, Sawney NS, Waggoner AD, et al. Prospective comparison of optimization methods for cardiac resynchronization therapy[J]. Heart Rhythm, 2006, 3(2): 148-154.
11. 　Kohl P, Bollensdorff C, Garny A. Effects of mechanosensitive ion channels on ventricular electrophysiology: experimental and theoretical models[J]. Exp Physiol, 2006, 91(2): 307-321.
12. 　Baker JH, McKenzie J, Beau S, et al. Acute evaluation of programmer-guided AV/PV and VV delay optimization comparing an IEGM method and echocardiogram for cardiac resynchronization therapy in heart failure patients and dual-chamber ICD implants[J]. J Cardiovasc Electrophysiol, 2007, 18(2): 185-191.

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Evaluation of the Optimized Algorithm for Interventricular Intervals in Biventricular Pacing Therapy

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