A Consistency Study Of Interventricular Delays Optimization For Cardiac Resynchronization Therapy By Modified Intracardiac Electrogram-based Method And Echocardiography

Objectives To investigate the consistency of interventricular delays optimization for cardiac resynchronization therapy by modified intracardiac electrogram(IEGM)-based method and echocardiography and assess whether the acute hemodynamic effects achieved by modified IEGM-based method are more effective and more accurate comparing with the traditional method.Methods A total number of20patients with congestive heart failure implanted with IEGM-based functioned CRT/CRT-D were enrolled. The follow-up period for all the patients after CRT was1,3and6months. Modified IEGM-based method,traditional IEGM-based method and echocardiography respectively was used to achieve the optimized VV delays and assessed the improvement degree of acute hemodynamic effects by the three different methods.Results the results showed the optimized W delays achieved by modified IEGM-based method have better agreeent and correlation with the echocardiographic optimization comparing with the traditional IEGM-based method. Theparameter of left ventricular ejection fraction (LVEF) by modified IEGM-based method was independently related to more favourable outcomes than the traditional echocardiography during the1,3and6months follow-up period (0.31±0.07vs0.29±0.08,0.37±0.07vs0.34±0.08,0.45±0.07vs0.42±0.08P<0.05). Moreover, the degree of the mitral regurgitation decreased markedly by modified IEGM-based method in6months follow-up after CRT(2.08±1.78vs2.64±2.37, P<0.05).However, there was no statistically significance between the traditional IEGM method and modified IEGM-based method in A Wave Velocity-time Integral (VTIAo) and the degree of the mitral regurgitation in1,3months follow-up after CRT(P>0.05).Conclusion1.The optimized VV delays achieved by modified IEGM-based method have better agreeent and correlation with the echo optimization comparing with the traditional IEGM-based method.2. The optimized VV delays achieved by modified IEGM-based method have better Acute hemodynamic effects.