Journal Article

11. Cardiac Resynchronization Therapy: Different Issues

B. Ismer, T. Körber, G.H. von Knorre, W. Voss, F. Weber, C. Melzer, H.H. Minden, C. Butter, J. Brandt and C.A. Nienaber

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 7, issue s3, pages S17-S17
Published in print October 2005 | ISSN: 1099-5129
Published online October 2005 | e-ISSN: 1532-2092 | DOI:
11. Cardiac Resynchronization Therapy: Different Issues

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Optimal AV delay (AVD) is the net effect of pacemaker related interatrial conduction time (IACT), duration of left atrial electromechanical action (LA-EAClong) and duration of left ventricular latency (Sv-EACshort): AVD = IACT + LA-EAClong − Sv-EACshort.


To study the influence of heart failure on the three AVD determinants.


The AVD determinants were measured by simultaneously recording mitral flow, telemetric sense event marker and filtered esophageal left atrial electrogram in 34 atrio-right-ventricular paced bradycardia patients without heart failure (group A) and 33 atrio-biventricular paced congestive heart failure patients (group B).


IACT in functional VDD (A: 33±28ms, B: 42±43ms, p = 0,753) and DDD mode (A: 112±20ms, B: 122±32ms, p = 0.076) as well as LA-EAClong (A: 192±20ms, B: 193±23ms, p = 0.836) did not differ significantly in both groups. In contrast, Sv-EACshort increased significantly in heart failure (A: 125±14ms, B: 147±22ms; p<0.001). The increase was about 13ms every 10% decrease in ejection fraction resulting in about 21 ms shorter AVD in group B.


Left ventricular latency is an indicator of reduced left ventricular function and the need for shorter individual AV delays in biventricular pacing.

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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