Document Detail

Should we optimize cardiac resynchronization therapy during exercise?
MedLine Citation:
PMID:  20550613     Owner:  NLM     Status:  In-Process    
Should We Optimize CRT During Exercise? Cardiac resynchronization therapy aims at diminishing cardiac dyssynchrony in patients with heart failure. The effect of cardiac resynchronization therapy can be improved by optimization of the atrioventricular (AV) and interventricular (VV) delays. Currently, optimization of these pacing settings is mainly performed during resting conditions. This paper aims to objectively review the current literature about a rate-adaptive AV and VV delay in cardiac resynchronization therapy. The current evidence for a rate-adaptive AV and VV delay comprises only small nonrandomized studies on acute effects. The effect of exercise on the optimal AV delay was heterogeneous between studies. The optimal VV delay was influenced by exercise conditions in some, but not all patients. Possible explanations lie in the heterogeneous electrical and mechanical responses to exercise in patients with a complex disease such as heart failure with asynchronous contraction. Current evidence is insufficient to show the superiority of a rate-adaptive AV or VV delay in all CRT patients. Individualized exercise programming may be warranted in selected patients.
Margot D Bogaard; J Hans Kirkels; Richard N W Hauer; Peter Loh; Pieter A Doevendans; Mathias Meine
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  21     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1307-16     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
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