Sažetak sa skupa

https://doi.org/10.15836/ccar2019.241

Effect of the ‘‘Search AV’’ feature on left ventricular longitudinal deformation and ProBNP levels in patients with implanted dualchamber pacemakers

Adem Yılmaz ; Kocaeli Gebze Fatih State Hospital, Department of Cardıology, Gebze, Turkey
Mustafa Serdar Yılmazer ; Maltepe University Medical School Hospital, Department of Cardiology, Maltepe, Turkey
Feyza Kurt ; Yalova State Hospital, Department of Cardiology, Yalova, Turkey

Sažetak

Introduction: Dual-chamber pacemaker implantation in patients with high grade AV block is a lifesaving
intervention. Unfortunately, one of the most important drawbacks is its ventricular stimulation
and the resultant LV systolic dysfunction due to left bundle brunch block. In recent years, in order to
avoid these drawbacks and to potentialize patients’ own intrinsic conduction, novel algorithms have
been developed by multiple pacemaker manufacturers. ‘‘Search AV’’ is one of the algorithms.1-3 This
study’s objective is to evaluate whether LV longitudinal deformation (assessed with automated function
imaging-AFI) will improve after engagement of the Search AV function. Secondary objective was
comparison of serum ProBNP values levels.
Patients and Methods: It is a cross-over design study where patients remained on solely pacemaker
stimulation for the first 30 days. During the second month, Search AV was engaged, and the abovementioned
parameters were evaluated. At zero-point, basic pacemaker and echocardiographic parameter
were measured. After 30 days, patients are switched to the “Search AV” group. After 4 weeks, the
second time battery control, Speckle Tracking Echocardiography (STE) based AFI with LV longitudinal
strain analysis was performed and ProBNP were measured. Echopac were analyzed with the program
again.
Results: In subgroup analysis, when the cut off value for RV pacing rate was considered to be %40, in
the group of ventricular pacing rate %40 and below, the decrement of ProBNP was found to be more
significant by comparing %40 and higher pacing rate group (p=0.001). The decrement of AFI values at
the end of the 2nd month were not statistically significant (p=0.189). However, when the cut off value
for RV pacing rate was considered to be %30 the AFI value which demonstrates the improvement of
LV function showed significant increasement (p=0.031) likewise statistically significant decrement of
ProBNP values (p=0.027).
Conclusion: Search AV is one these algorithms which reduces ventricular artificial stimulation with
compromising patients’ lifes. When adjusting these algorithms, target the RV pacing rate should be
below % 30, not % 40 as mentioned in the previously published papers. Indeed, further long-term prospective
studies with homogenous patients are needed to prove this argument.

Ključne riječi

search AV; strain; speckle tracking echocardiography; Pro-BNP; dual-chamber pacemaker.

Hrčak ID:

226710

URI

https://hrcak.srce.hr/226710

Datum izdavanja:

15.10.2019.

Posjeta: 593 *