Echocardiography-guided pacemaker optimization and radial artery tonometry

Journal of Cardiac Failure
Tasneem Z Naqvi, Asim M Rafique

Abstract

Biventricular (Biv) pacemaker optimization is underused because of time and echo skill required. We evaluated radial artery tonometry during echo-guided Biv optimization of atrioventricular (AV) and interventricular (VV) delays. A total of 60 patients (67 +/- 10 years) underwent simultaneous radial artery tonometry and echocardiography after Biv implant at baseline, short AV delay, and optimal AV delay. Twenty of these also underwent VV optimization. Optimal AV delay was determined by ejection duration (E-dur) of left ventricular (LV) outflow tract by pulsed-waved (PW) Doppler (LV(E-dur)) and mitral inflow PW Doppler pattern and optimal VV delay by LV(E-dur) and tissue Doppler. E-dur was also measured from radial artery pulse wave (RA(E-dur)). AV optimization improved LV(E-dur) from 249 +/- 35 to 260 +/- 38 ms (P < .01) and RA(E-dur) from 276 +/- 31 ms to 284 +/- 32 ms (P = .02). Correlation between LV(E-dur) and by RA(E-dur) was 0.83 (95% CI 0.75-0.92). RA(E-dur) was 282.53 +/- 30 at baseline, 286.65 +/- 36 at optimal AV delay (P < .04 vs. baseline) and 286.90 +/- 35 ms (P < .04 vs. baseline) at optimal AV and VV delay in those who underwent VV optimization. AV and VV optimization by echocardiography produces significant impro...Continue Reading

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Citations

Mar 10, 2012·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Frank EberhardtUwe K H Wiegand
Nov 13, 2010·JACC. Cardiovascular Imaging·Tasneem Z Naqvi
May 15, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Asim M RafiqueTasneem Z Naqvi
Jun 8, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·José M DizonHasan Garan
Dec 10, 2017·Pacing and Clinical Electrophysiology : PACE·Giuseppe CiconteCarlo Pappone
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May 22, 2021·American Journal of Physiology. Heart and Circulatory Physiology·Jing Liu, Niema M Pahlevan

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