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Visualization of the SyncAV(®) Algorithm for CRT Optimization by Non-invasive Imaging of Cardiac Electrophysiology: NICE-CRT Trial

(1) Background: Periodic repetitive AV interval optimization using a device-based algorithm in cardiac resynchronization therapy (CRT) devices may improve clinical outcomes. There is an unmet need to successfully transform its application into clinical routine. (2) Methods: Non-invasive imaging of c...

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Autores principales: Spitaler, Philipp, Pfeifer, Bernhard Erich, Mayr, Agnes, Bachler, Rudolf, Bilgeri, Valentin, Adukauskaite, Agne, Bauer, Axel, Stühlinger, Markus, Barbieri, Fabian, Dichtl, Wolfgang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342787/
https://www.ncbi.nlm.nih.gov/pubmed/37445543
http://dx.doi.org/10.3390/jcm12134510
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author Spitaler, Philipp
Pfeifer, Bernhard Erich
Mayr, Agnes
Bachler, Rudolf
Bilgeri, Valentin
Adukauskaite, Agne
Bauer, Axel
Stühlinger, Markus
Barbieri, Fabian
Dichtl, Wolfgang
author_facet Spitaler, Philipp
Pfeifer, Bernhard Erich
Mayr, Agnes
Bachler, Rudolf
Bilgeri, Valentin
Adukauskaite, Agne
Bauer, Axel
Stühlinger, Markus
Barbieri, Fabian
Dichtl, Wolfgang
author_sort Spitaler, Philipp
collection PubMed
description (1) Background: Periodic repetitive AV interval optimization using a device-based algorithm in cardiac resynchronization therapy (CRT) devices may improve clinical outcomes. There is an unmet need to successfully transform its application into clinical routine. (2) Methods: Non-invasive imaging of cardiac electrophysiology was performed in different device programming settings of the SyncAV(®) algorithm in 14 heart failure patients with left bundle branch block and a PR interval ≤ 250 milliseconds to determine the shortest ventricular activation time. (3) Results: the best offset time (to be manually programmed) permitting automatic dynamic adjustment of the paced atrioventricular interval after every 256 heart beats was found to be 30 and 50 milliseconds, decreasing mean native QRS duration from 181.6 ± 23.9 milliseconds to 130.7 ± 10.0 and 130.1 ± 10.5 milliseconds, respectively (p = 0.01); this was followed by an offset of 40 milliseconds (decreasing QRS duration to 130.1 ± 12.2 milliseconds; p = 0.08). (4) Conclusions: The herein presented NICE-CRT study supports the current recommendation to program an offset of 50 milliseconds as default in patients with left bundle branch block and preserved atrioventricular conduction after implantation of a CRT device capable of SyncAV(®) optimization. Alternatively, offset programming of 30 milliseconds may also be applied as default programming. In patients with no or poor CRT response, additional efforts should be spent to individualize best offset programming with electrocardiographic optimization techniques.
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spelling pubmed-103427872023-07-14 Visualization of the SyncAV(®) Algorithm for CRT Optimization by Non-invasive Imaging of Cardiac Electrophysiology: NICE-CRT Trial Spitaler, Philipp Pfeifer, Bernhard Erich Mayr, Agnes Bachler, Rudolf Bilgeri, Valentin Adukauskaite, Agne Bauer, Axel Stühlinger, Markus Barbieri, Fabian Dichtl, Wolfgang J Clin Med Article (1) Background: Periodic repetitive AV interval optimization using a device-based algorithm in cardiac resynchronization therapy (CRT) devices may improve clinical outcomes. There is an unmet need to successfully transform its application into clinical routine. (2) Methods: Non-invasive imaging of cardiac electrophysiology was performed in different device programming settings of the SyncAV(®) algorithm in 14 heart failure patients with left bundle branch block and a PR interval ≤ 250 milliseconds to determine the shortest ventricular activation time. (3) Results: the best offset time (to be manually programmed) permitting automatic dynamic adjustment of the paced atrioventricular interval after every 256 heart beats was found to be 30 and 50 milliseconds, decreasing mean native QRS duration from 181.6 ± 23.9 milliseconds to 130.7 ± 10.0 and 130.1 ± 10.5 milliseconds, respectively (p = 0.01); this was followed by an offset of 40 milliseconds (decreasing QRS duration to 130.1 ± 12.2 milliseconds; p = 0.08). (4) Conclusions: The herein presented NICE-CRT study supports the current recommendation to program an offset of 50 milliseconds as default in patients with left bundle branch block and preserved atrioventricular conduction after implantation of a CRT device capable of SyncAV(®) optimization. Alternatively, offset programming of 30 milliseconds may also be applied as default programming. In patients with no or poor CRT response, additional efforts should be spent to individualize best offset programming with electrocardiographic optimization techniques. MDPI 2023-07-05 /pmc/articles/PMC10342787/ /pubmed/37445543 http://dx.doi.org/10.3390/jcm12134510 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Spitaler, Philipp
Pfeifer, Bernhard Erich
Mayr, Agnes
Bachler, Rudolf
Bilgeri, Valentin
Adukauskaite, Agne
Bauer, Axel
Stühlinger, Markus
Barbieri, Fabian
Dichtl, Wolfgang
Visualization of the SyncAV(®) Algorithm for CRT Optimization by Non-invasive Imaging of Cardiac Electrophysiology: NICE-CRT Trial
title Visualization of the SyncAV(®) Algorithm for CRT Optimization by Non-invasive Imaging of Cardiac Electrophysiology: NICE-CRT Trial
title_full Visualization of the SyncAV(®) Algorithm for CRT Optimization by Non-invasive Imaging of Cardiac Electrophysiology: NICE-CRT Trial
title_fullStr Visualization of the SyncAV(®) Algorithm for CRT Optimization by Non-invasive Imaging of Cardiac Electrophysiology: NICE-CRT Trial
title_full_unstemmed Visualization of the SyncAV(®) Algorithm for CRT Optimization by Non-invasive Imaging of Cardiac Electrophysiology: NICE-CRT Trial
title_short Visualization of the SyncAV(®) Algorithm for CRT Optimization by Non-invasive Imaging of Cardiac Electrophysiology: NICE-CRT Trial
title_sort visualization of the syncav(®) algorithm for crt optimization by non-invasive imaging of cardiac electrophysiology: nice-crt trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342787/
https://www.ncbi.nlm.nih.gov/pubmed/37445543
http://dx.doi.org/10.3390/jcm12134510
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