Iterative Cardiac Output Measurement for Optimizing Cardiac Resynchronization Therapy: A Randomized, Blinded, Crossover Study

作者：Reinsch Nico^*; Konorza Thomas; Woydowski Dagmar; Bruck Heike; Volsek Michaela; Mueller Tasch Thomas; Neumann Till; Erbel Raimund; Wieneke Heinrich

来源：Pacing and Clinical Electrophysiology, 2010, 33(10): 1188-1194.

DOI：10.1111/j.1540-8159.2010.02848.x

• CRT
• optimization
• inert gas rebreathing
• cardiac output
• cardiac exercise capacity

Methods: In 24 patients on CRT, iterative VV- and AV-delay optimization was done using the IGR method. This blinded, randomized, crossover study compared the responses to optimization during two periods: a 4-week optimized and a 4-week standard programming. Exercise capacity after optimization was assessed after each period by New York Heart Association (NYHA) classification, a 6-minute walking test, and quality of life (QoL) questionnaire.
Results: CO could be determined by IGR in all patients. The NYHA class decreased by 17.8% (2.8 +/- 0.3 vs 2.3 +/- 0.4, P < 0.001), the mean (+/- standard deviation) distance walked in 6 minutes was 9.3% greater after optimization (456 +/- 140 m vs 417 +/- 134 m, P < 0.001), and the QoL improved by 14.5% (41.8 +/- 10.4 vs 36.5 +/- 9.5, P < 0.001). The portion of responders to CRT increased from 66.5% to 87.5%.
Conclusion: CRT optimization by iterative CO measurements leads to an increase in CO and an improvement of exercise capacity. Our results suggest that this method might become an important additive tool to adjust CRT programming. (PACE 2010; 33:1188-1194).

• 出版日期2010-10