Abstract
In this trial, long-term therapeutic effects and clinical improvements in Chinese chronic heart failure patients optimized by QuickOpt or echocardiography were compared for atrioventricular (AV) and interventricular (VV) delay optimizations after cardiac resynchronization therapy (CRT) with pacing (CRT-P) or with pacing and defibrillator (CRT-D) therapy. One hundred and ninety-six subjects (50%) had dilated cardiomyopathy, 108 (27.6%) had ischemic heart disease and 112 (28.6%) were hypertensive and were randomized into QuickOpt (198) or echocardiographic optimization (control) (194) groups at ≤2-weeks post-implantation. Programmed AV/VV delay was optimized at baseline and at 3 and 6 months. Left ventricular end-systolic volume (LVESV), New York Heart Association (NYHA) class, specific activity scale (SAS), and the six-minute walk tests (6MWT) were evaluated by blinded researchers at 12 months. Of the QuickOpt group, LVESV decreased significantly by 24.7% ± 33.9% compared with baseline, while LVESV of Controls decreased by 25.1% ± 36.1% (P = 0.924). NYHA class, SAS and 6MWT also improved similarly in both groups at 12 months. Mortality in both groups was not significantly different (11.0% vs 7.6%, P = 0.289). However, there was a significant difference in the time required for optimization by QuickOpt compared with echocardiography (3.33 ± 3.11 vs 58.79 ± 27.03 minutes, P < 0.000).
Highlights
In this trial, long-term therapeutic effects and clinical improvements in Chinese chronic heart failure patients optimized by QuickOpt or echocardiography were compared for atrioventricular (AV) and interventricular (VV) delay optimizations after cardiac resynchronization therapy (CRT) with pacing (CRT-P) or with pacing and defibrillator (CRT-D) therapy
Based on the inclusion criteria, 400 patients with Congestive heart failure (CHF) in 31 different hospitals from May 2010 to February 2015 were implanted with CRT-P (260 patients) or CRT-D (140 patients) and they were automatically assigned into the QuickOpt and Echo groups for optimization in a 1:1 ratio by software which linked in all the sites
The mean age of the QuickOpt group was 61.38 ± 11.77 years and the echocardiography group 59.21 ± 11.36 years. 196 patients were diagnosed with dilated cardiomyopathy and 112 patients with hypertension, 47 patients with diabetes and
Summary
Long-term therapeutic effects and clinical improvements in Chinese chronic heart failure patients optimized by QuickOpt or echocardiography were compared for atrioventricular (AV) and interventricular (VV) delay optimizations after cardiac resynchronization therapy (CRT) with pacing (CRT-P) or with pacing and defibrillator (CRT-D) therapy. Common approaches to define the best AV interval rely on repeated echocardiographic assessments with program adjustments (iterative) and other methods[12,13], with the aim of interval optimization to reduce left ventricular dyssynchrony and mitral regurgitation. Optimization of both atrioventricular (AV) and ventricular-ventricular (VV) intervals improves the therapeutic effects of CRT14,15
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