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A comparison of acoustic cardiography and echocardiography for optimizing pacemaker settings in cardiac resynchronization therapy

Zuber, M. and Toggweiler, S. and Quinn-Tate, L. and Brown, L. and Amkieh, A. and Erne, P.. (2008) A comparison of acoustic cardiography and echocardiography for optimizing pacemaker settings in cardiac resynchronization therapy. Pacing and clinical electrophysiology, Vol. 31, H. 7. pp. 802-811.

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Official URL: http://edoc.unibas.ch/dok/A6006701

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Abstract

BACKGROUND: Cardiac resynchronization therapy (CRT) is useful in managing patients with refractory heart failure. To increase efficacy, pacemaker settings are optimized, with Doppler echocardiography being the preferred method. Recently, acoustic cardiography, an automated method that records, analyzes, and displays simultaneous ECG and heart sound data, has been developed. In this study, the suitability of acoustic cardiography as an alternative to Doppler echocardiography in CRT optimization is evaluated. METHODS: We studied 43 CRT patients undergoing optimization. Using Doppler echocardiography, we determined the optimal atrioventricular (AV) delay with a transmitral flow assessment. For optimization of the interventricular (VV) delay, we used the left ventricular outflow tract velocity time integral (VTI). For acoustic cardiography, we used the electromechanical activation time (EMAT, the interval from QRS onset to the S1). Reproducibility of echocardiography and acoustic cardiography was determined by programming 10 different delay settings twice in random order. RESULTS: All 43 subjects underwent AV optimization, and 14 had CRT devices allowing VV optimization. While the intraobserver variability of EMAT and Doppler echocardiography parameter was similar (9.9% vs 8.5%), the reproducibility of EMAT was the highest (r = 0.91) and VTI was the lowest (r = 0.35). The correlation between the optimal AV delays determined by EMAT versus transmitral flow assessment was 0.86 (P > 0.001). The correlation between the optimal VV delays determined by EMAT versus VTI was 0.58 (P > 0.05), perhaps due to the poor reproducibility of the VTI. CONCLUSION: For CRT optimization, acoustic cardiography provides results similar to echocardiography but with improved reproducibility and ease of use.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Further Research Groups at DBM > Signal Transduction (Resink/Erne)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie
UniBasel Contributors:Zuber, Michel and Erne, Paul
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Blackwell Futura Publishing
ISSN:0147-8389
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:13 Sep 2013 07:59
Deposited On:13 Sep 2013 07:50

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