Original scientific paper

https://doi.org/10.20471/acc.2017.56.04.06

Manual Intracardiac Electrogram Method Is Accurate Alternative to Echocardiography for Atrioventricular and Interventricular Optimization in Cardiac Resynchronization Therapy

Borka Pezo Nikolić ; Department of Cardiovascular Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Daniel Lovrić ; Department of Cardiovascular Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Jana Ljubas Maček ; Department of Cardiovascular Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Vlatka Rešković Lukšić ; Department of Cardiovascular Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Richard Matasić ; Department of Cardiovascular Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Jadranka Šeparović Hanževački ; Department of Cardiovascular Medicine, Zagreb University Hospital Centre, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia

Abstract

Some manufacturers do not provide automated intracardiac electrogram method (IEGM) systems for atrioventricular (AV) and interventricular (VV) delay optimization in cardiac resynchronization therapy (CRT). We aimed to evaluate the accuracy of manual IEGM method in 48 patients previously implanted with Medtronic Syncra CRT. All patients underwent standard device interrogation followed by CRT optimization by IEGM method and by echocardiography one month after implantation. The patient mean age was 60.7±11.8 years and there were 33 (68.8%) males. After CRT implantation, the left ventricular ejection fraction increased from 28.0±7.9% to 39.1±11.0% (p<0.001). Optimal aortic flow Velocity Time Integral (aVTI) was obtained when VV was set to 20-50 ms left ventricular pre-activation. There was a strong correlation between VV values determined by echocardiography and IEGM (R=0.823, p<0.001). We found no significant difference in AV, VV and aVTI values between echocardiography and IEGM method. However, IEGM was significantly less time-consuming than echocardiography [20 (10-28) vs. 40 (35-60) minutes, p<0.001]. Manual IEGM method may be good alternative to echocardiography and automated IEGM method. It also emphasizes the need for implementation of automated IEGM systems in as many CRT devices as possible.

Keywords

Intracardiac electrogram; Optimization; Cardiac resynchronization therapy; Atrioventricular delay; Interventricular VV delay

Hrčak ID:

195426

URI

https://hrcak.srce.hr/195426

Publication date:

15.12.2017.

Article data in other languages: croatian

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