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Echocardiographic Improvements with Pacemaker Optimization in the Chronic Post Cardiac Resynchronization Therapy Setting

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Publication Date: 29 Feb 2008

Journal: Clinical Medicine Insights: Cardiology Clinical Medicine: Cardiology 2008:2 65-74

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Abstract Alan J. Bank1,2, Kevin V. Burns1, Aaron S. Kelly1,2, Andrea M. Thelen1, Christopher L. Kaufman1 and Stuart W. Adler1

1Department of Research, St. Paul Heart Clinic, St. Paul, MN. 2School of Medicine, University of Minnesota, Minneapolis, MN.

Abstract

The current study assessed the acute effects of pacemaker optimization (PMO) on cardiac function using echocardiographic (ECHO) tissue Doppler imaging (TDI) in the post CRT setting. Data were analyzed from 50 consecutive patients clinically referred for PMO. Patients underwent a sequential ECHO/TDIguided PMO study to determine optimal pacemaker settings. In 34 of 50 patients a change in pacemaker settings was made because of an objective improvement in ECHO/TDI findings.

Overall, significant improvements were observed for ECHO/TDI measures of systolic function (global systolic contraction score, p < 0.001; ejection time, p < 0.05), diastolic function (diastolic filling period, p < 0.01; mitral velocity-time integral,p < 0.05) and left ventricular (LV) dyssynchrony (standard deviation of time to peak displacement, p < 0.05). In most patients referred for chronic PMO, ECHO/TDI-guided PMO can be used to objectively improve cardiac systolic function, diastolic function and/or LV dyssynchrony.


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