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Definition of the Optimal Atrioventricular Delay by Simultaneous Measurement of Electrocardiographic and Doppler Echocardiographic Parameters
- Publisher
- Springer Journals
- Copyright
- Copyright © 2006 by Steinkopff-Verlag
- Subject
- Medicine & Public Health; Cardiology
- ISSN
- 0938-7412
- eISSN
- 1435-1544
- DOI
- 10.1007/s00399-006-1106-8
- pmid
- 16598620
- Publisher site
- See Article on Publisher Site
Abstract
In DDD pacing, the left-ventricular electromechanical latency period defines the duration between premature ventricular stimulation and the prematurely ending left-atrial contribution to left-ventricular filling. It has to be considered in diastolic AV delay optimization. Individual duration of this parameter seemed to reflect the ventricular function. Therefore, we compared the left-ventricular electromechanical latency period due to right ventricular stimulus with the documented ejection fraction of two groups, 33 congestive heart failure patients carrying biventricular systems and 13 right ventricular paced bradycardia patients. A mean latency period of 168±26 ms was found in the heart failure patients (ejection fraction: 25±5%) which was significantly longer (p=0.0039) compared to the bradycardia patients (ejection fraction: 51±12%) with a mean latency of 119±13 ms. Thus, an increasing latency period during right ventricular DDD pacing therapy indicates decreasing ejection fraction. A cut-off interval of 135 ms allowed the discrimination of 93% of our patients as having an individual ejection fraction of either up to 35% or above. Thus, the left ventricular electromechanical latency period can be used as an additional parameter indicating the neccesity to upgrade from right to biventricular DDD pacing.
Journal
Herzschrittmachertherapie + Elektrophysiologie – Springer Journals
Published: Jan 1, 2006