Abstract
Methods:We evaluated 20 patients (18 male, aged 66± 11 years, mean time since pacemaker implant 180± 11 days). Echocardiography and 6minwalk test (6MWT)were used to measure cardiac function (cardiac output [CO] and stroke volume [SV]) and functional capacity, respectively, before and after optimisation of CRT. Optimal VV delay was defined as that associatedwith highest left ventricular outflow tract velocity time integral. Results: As expected, VV optimisation immediately improved SV (58± 20ml vs. 64± 22ml, p= 0.005) and cardiac output (4.02± 1.23 L/min vs. 4.42± 1.35 L/min, p= 0.006). In addition, there was a significant increase in 6 MWT distance (403± 113m vs. 433± 101m, p= 0.018) with optimisation. However, there was no significant correlation between 6MWT distance and SV or CO, either for absolute values, or for the changes induced by optimisation (r 0.16 for all). Conclusion: Echocardiography guided VV optimisation produces immediate and significant functional improvements that are independent of haemodynamic measures in patients undergoing optimisation of CRT. doi:10.1016/j.hlc.2008.05.296
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