Objective
Cardiac resynchronization treatment (CRT) is a way of treatment which is recommended in the current guidelines for the patients in sinus rhythm whose survival for a year is expected and whose EF≤35%, QRS duration ≥120 ms and who have LBBB morphology and also for the patients in sinus rhythm whose QRS duration ≥150 ms not withstanding the morphology. In many randomized controlled studies, although the rate of the treatment response is high, there is a patient group of 20-30% who do not respond to the treatment. As a result of small randomized uncontrolled studies made in these patients, biventricular pacemaker optimisation is recommended in guidelines. Although the best optimisation techniques are invasive techniques, non-invasive techniques are used (preferred) more on account of applicability and affordability. In our study, we made atrioventricular (AV) optimisation with echocardiographic techniques to the patients whom were applied CRT and we evaluated the hemodynamical changes occurred as a result of optimisation by means of impedance cardiography which is again a non-invasive technique. We aimed to search the benefit of the optimisation operation in patients with biventricular pacemaker.
Methods-Results
10 male (50%) and 10 female (50%) patients (totally 20) who were implanted biventricular pacemaker were included in the study. There was ischemic cardiomyopathy diagnosis in 5 patients (25%) and non-ischemic cardiomyopathy diagnosis in 15 patients (75%). None of the patients were applied optimisation before. The average EF was % 42.25±10.75, the average QRS duration was 121.40±14.97 msn. We used Iterative technique, Mitral Inflow VTİ and Aortic Valve VTİ for optimisation. In the evaluation after optimisation, statistically significant increases were determined in Mitral Inflow VTİ and Aortic Valve VTİ determined with echocardiography. Although little increases were observed in cardiac output and cardiac indexes determined with impedance cardiography, statistically significant variation was not observed.
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