Document Detail

A novel methodology for AV and VV delay optimization in CRT: results from a randomized pilot clinical trial.
MedLine Citation:
PMID:  23504186     Owner:  NLM     Status:  Publisher    
The aim of this work was to determine whether the use of a newly developed methodology (Alg1) for AV and VV optimization improves cardiac resynchronization therapy (CRT) clinical and echocardiographic (ECHO) outcomes. In this single-center pilot clinical trial, 80 consecutive patients (79 % male; 70.1 ± 11.2 years) receiving CRT were randomly assigned to AV and VV optimization using Alg1 (group A) or standard commercial procedures (group B). Clinical status and ECHOs were analyzed at baseline (_0) , 3 (fu1), and 6 months (fu2) of follow-up evaluating left ventricular end systolic (LVESV) and end diastolic (LVEDV) volumes, ejection fraction (EF), Minnesota test, and 6-min walk test (6MWT). Alg1 is based on a cardiovascular model fed with patient data. Baseline characteristics did not differ significantly between groups. Group A had a better clinical outcome and reverse remodeling. Remodeling was calculated as the difference (Δ) between fu1 and _0 and between fu2 and fu1, respectively: [LVESV (ml): ΔA_fu1 = -55.3, ΔB_fu1 = -13.5, p_fu1 = 0.002; ΔA_fu2 = -22.8, ΔB_fu2 = 3.0, p_fu2 = 0.04], [LVEDV (ml): ΔA_fu1 = -61.9, ΔB_fu1 = -16.1, p_fu1 = 0.01; ΔA_fu2 = -30.4, ΔB_fu2 = 11.3, p_fu2 = 0.02]; Minnesota test: total (p_fu1 = 0.01; p_fu2 = 0.04), physical (p_fu1 = 0.01; p_fu2 = 0.03) and emotional scores (p_fu1 = 0.04; p_fu2 = 0.03) and in 6MWT (m) (p_fu2 = 0.008). No statistically significant difference was observed in QRS width. Compared with current standard of care, CRT optimization using Alg1 is associated with better outcomes, showing the power of a tailored CRT.
Arianna Di Molfetta; Giovanni B Forleo; Luca Santini; Libera Fresiello; Lida P Papavasileiou; Giulia Magliano; Domenico Sergi; Ambrogio Capria; Francesco Romeo; Gianfranco Ferrari
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-16
Journal Detail:
Title:  Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs     Volume:  -     ISSN:  1619-0904     ISO Abbreviation:  J Artif Organs     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815648     Medline TA:  J Artif Organs     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Cardiovascular Engineering Group, Institute of Clinical Physiology, Italian National Research Council, via San Martino della Battaglia, 44, 00185, Rome, Italy,
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