Adaptive CRT algorithm and electrical synchrony

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main source(s): United Hospital Medical Education and Research Committee, Background We have previously shown that optimization cardiac resynchronization therapy (CRT) nonresponders using a novel electrical dyssynchrony mapping (EDM) system significantly improves dyssynchrony, left ventricle (LV) size systolic function. Whether this methodology can improve (and potentially LV function) in nonresponder patients programmed with the adaptive CRT (aCRT) algorithm is not known. Purpose To quantify aCRT determine if it be improved EDM. Methods studied 97 at multiple device settings an ECG 9 anterior posterior electrodes. quantified measure wavefront fusion, index (CRI), calculated as % change area under curve between all combinations electrodes compared to native LBBB (CRT off). CRI results were displayed on map showing atrial-to-right ventricle-paced intervals (A-RVp) y-axis atrial-to-left (A-LVp) x-axis. Results Figure 1 shows EDM for typical patient values marked different settings. 2 58 LV-only by baseline (red bars) 39 biventricular (BiV) (blue bars). was (p≤0.001) higher vs. those BiV. In both groups programming optimal atrial-ventricular delay (AVD) sequential BiV pacing ventricular-ventricular (VVD) produced markedly better LV-only, VV=0 standard setting (SAV 120 ms) had worse than baseline. Conclusions Electrical measured 20% or more program AVD VVD. technology offers possibility substantially improving synchrony aCRT.