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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Programmed versus effective VV delay during CRT optimization: When what you see is not what you get
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Programmed versus effective VV delay during CRT optimization: When what you see is not what you get

机译：CRT优化过程中的编程VV延迟与有效VV延迟：当您看到的不是您得到的时

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Background In cardiac resynchronization therapy (CRT) devices, the interventricular (VV) delay denotes the time interval between left (LV) and right ventricular (RV) pacing. This study aimed to determine the proportion of patients in whom the effective VV delay (VVeff, delay between LV and RV depolarization, being induced either by pacing or intrinsic conduction) is different from the programmed VV delay during a standard VV delay optimization procedure. Methods Thirty-three patients with heart failure and left bundle branch block configuration without total atrioventricular (AV) block receiving CRT were prospectively included. VVeff was calculated from intrinsic AV intervals, programmed optimal AV delay, and programming system. Intrinsic AV intervals were measured on intracardiac electrograms. The optimal AV and VV delays were determined by highest increase in maximum rate of LV pressure rise (dP/dtmax). VV delays of 20-80 ms LV and RV preactivation were tested. Results Calculated maximum possible VVeff was shorter than 80 ms LV preactivation in up to 46% of patients and shorter than 40 ms LV preactivation in up to 3% of the patients. These proportions were 6% and 0% during 80 and 40 ms RV preactivation, respectively. Conclusions In CRT patients with left bundle branch block without total AV block, the effective VV delay is shorter than the programmed VV delay during a standard optimization procedure in approximately half of the patients and this phenomenon is encountered predominantly during LV preactivation by 40 ms or more. Calculation of the individual maximum VVeff in advance can shorten the VV delay optimization procedure.
机译：背景技术在心脏再同步治疗（CRT）设备中，心室（VV）延迟表示左（LV）和右心室（RV）起搏之间的时间间隔。这项研究旨在确定在标准VV延迟优化程序中，有效VV延迟（VVeff，LV和RV去极化之间的延迟，由起搏或固有传导引起）与已编程的VV延迟不同的患者比例。方法前瞻性纳入33例心力衰竭，左束支传导阻滞，无完全房室传导阻滞的患者接受CRT治疗。 VVeff是根据固有AV间隔，已编程的最佳AV延迟和编程系统计算得出的。在心内电描记图上测量固有AV间隔。最佳的AV和VV延迟由最大的LV压力上升速率（dP / dtmax）的最大增加确定。测试了20-80毫秒LV和RV预激活的VV延迟。结果在最大46％的患者中，计算出的最大可能VVeff小于80 ms LV预激活，并且在多达3％的患者中小于40 ms LV预激活。在RV预激活80和40 ms期间，这些比例分别为6％和0％。结论在具有左束支传导阻滞而无总房室传导阻滞的CRT患者中，大约一半的患者在标准优化过程中，有效VV延迟比编程的VV延迟短，这种现象主要发生在LV预激活40 ms或更长时间内。提前计算单个最大VVeff可以缩短VV延迟优化过程。

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