| Novel method of biventricular pacemaker optimization by radial artery tonometer. A case report. | |
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MedLine Citation:
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PMID: 17534257 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Echocardiographic guided pacemaker optimization leads to significant improvement in cardiac function among nonresponders to cardiac resynchronization treatment (CRT). Simpler, noninvasive determination of cardiac function during biventricular pacemaker programming may simplify this procedure. In this report we describe a 73 year old male patient who presented with recent onset NYHA class III symptoms 7 months post-CRT for ischemic cardiomyopathy. During pacemaker optimization using A-pacing at 60 bpm, optimal atrioventricular (AV) delay was found to be 290 ms by both pulsed wave (PW) echo Doppler as well as by the simultaneously measured radial artery pulse waveform analysis by tonometry. No discernable atrial mechanical activity was visible despite presence of sinus rhythm up to an AV delay of 190 ms. Further improvement in cardiac function and decrease in mechanical dyssynchrony was shown with VV optimization by tissue Doppler imaging (TDI). Our report emphasizes the need for individualized biventricular pacemaker optimization post-CRT and that concomitant assessment via radial artery pulse waveform analysis by tonometry along with PW and TDI may provide additional information during pacemaker programming to assist in pacemaker optimization. |
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Authors:
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A M Rafique; T Z Naqvi |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Minerva cardioangiologica Volume: 55 ISSN: 0026-4725 ISO Abbreviation: Minerva Cardioangiol Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-05-30 Completed Date: 2007-10-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0400725 Medline TA: Minerva Cardioangiol Country: Italy |
Other Details:
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Languages: eng Pagination: 385-9 Citation Subset: IM |
Affiliation:
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Cardiac Noninvasive Laboratory, Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Echocardiography, Doppler Electrocardiography Heart Failure / physiopathology, therapy*, ultrasonography Humans Male Pacemaker, Artificial* Pulse* Radial Artery* Treatment Outcome |
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