Cardiac output response to changes of the atrioventricular delay in different body positions and during exercise in patients receiving cardiac resynchronization therapy

  • Ståhlberg M
  • Damgaard M
  • Norsk P
 et al. 
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Abstract

AIMS: The aim of this study was to study the haemodynamic effect of atrioventricular delay (AVD) modifications within a narrow range in different body positions and during exercise in patients receiving cardiac resynchronization therapy (CRT).

METHODS: The previously optimized AVD was shortened and prolonged by 40 ms in 27 CRT patients and 9 controls without heart failure. Cardiac output (CO) was measured by inert gas rebreathing (Innocor) as the average over different body positions (left-lateral, supine, sitting, standing, and exercise). In eight CRT patients with an implantable haemodynamic monitor, the estimated pulmonary artery diastolic pressure (ePAD) was analysed.

RESULTS: The magnitude of CO response to AVD changes was greater in CRT patients than in controls (0.25 vs. 0.20 L/min, P
CONCLUSION: The haemodynamic response to AVD modifications within a narrow range is larger in CRT patients than in normal controls and varies substantially between individuals. These findings suggest that optimal AVD tuning is clinically important in selected patients.

Author-supplied keywords

  • Atrioventricular delay
  • Body position
  • Cardiac output
  • Cardiac resynchronization therapy
  • Exercise
  • Heart failure

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Authors

  • Marcus StahlbergJohns Hopkins Medicine

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  • Morten Damgaard

  • Peter Norsk

  • Anders Gabrielsen

  • Anders Sahlén

  • Cecilia Linde

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