0329 : Automatic AV delay adaptation to exercise in CRT-D patients according to underlying heart disease

Abstract

Several studies have shown the benefit of optimizing inter-ventricular (VV) and atrio-ventricular (AV) delays in improving the response to CRT. We evaluated AV delay automatic adaptation at rest and during exercise according to underlying heart disease in patients implanted with a SonR CRT-D device (Sorin CRM, Clamart, France). This device is connected to the atrial SonRTip™ lead with a hemodynamic SonR sensor allowing automatic weekly AV and VV delays optimization, at rest and exercise. This prospective study evaluated patients implanted with a SonR CRT-D device in our center between November 2011 and November 2014. Only patients in sinus rhythm with a CRT optimization function programmed “on” were included. Optimization success was evaluated according to the percentage of weeks where the device succeeded AV delay optimization. Twenty-nine patients (67.8±9 years; 75.9% M) were included: 14 (48.2%) had an ischemic cardiomyopathy (ICM) and 15 (51.8%) a dilated cardiomyopathy (DCM). QRS duration was 165 ±19 msec. LVEF was 28±5%. AV delay at rest was 87±14 msec. and at exercise 54±7 msec. No difference was found between both groups (ICM and DCM). In ICM group, 11 (78,6%) patients were responders (optimization success 99%) and non-responders (optimization success 66%). In the DCM group, 4 (26,7%) patients were hyper-responders, 6 (40%) responders and 5 (33,3%) non-responders with respectively 99, 97 and 60% of optimization success. no difference was found in AV delay mean values in responders and nonresponders in both groups. AV delay automatic adaptation at exercise in patients implanted with the SonR CRT-D device was not different between ICM and DCM patients. The author hereby declares no conflict of interest