Echocardiography-Guided Pacemaker Optimization and Radial Artery Tonometry

Tasneem Z. Naqvi; Asim M. Rafique

doi:10.1016/j.cardfail.2008.02.013

Echocardiography-Guided Pacemaker Optimization and Radial Artery Tonometry

Tasneem Z. Naqvi, Asim M. Rafique

Cardiovascular Diseases

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Background: Biventricular (Biv) pacemaker optimization is underused because of time and echo skill required. We evaluated radial artery tonometry during echo-guided Biv optimization of atrioventricular (AV) and interventricular (VV) delays. Methods and Results: A total of 60 patients (67 ± 10 years) underwent simultaneous radial artery tonometry and echocardiography after Biv implant at baseline, short AV delay, and optimal AV delay. Twenty of these also underwent VV optimization. Optimal AV delay was determined by ejection duration (E-dur) of left ventricular (LV) outflow tract by pulsed-waved (PW) Doppler (LV_E-dur) and mitral inflow PW Doppler pattern and optimal VV delay by LV_E-dur and tissue Doppler. E-dur was also measured from radial artery pulse wave (RA_E-dur). AV optimization improved LV_E-dur from 249 ± 35 to 260 ± 38 ms (P < .01) and RA_E-dur from 276 ± 31 ms to 284 ± 32 ms (P = .02). Correlation between LV_E-dur and by RA_E-dur was 0.83 (95% CI 0.75-0.92). RA_E-dur was 282.53 ± 30 at baseline, 286.65 ± 36 at optimal AV delay (P < .04 vs. baseline) and 286.90 ± 35 ms (P < .04 vs. baseline) at optimal AV and VV delay in those who underwent VV optimization. Conclusions: AV and VV optimization by echocardiography produces significant improvement in LV_E-dur and RA_E-dur. Radial artery tonometry may provide a simple noninvasive method to assist in AV delay optimization.

Original language	English (US)
Pages (from-to)	583-589
Number of pages	7
Journal	Journal of Cardiac Failure
Volume	14
Issue number	7
DOIs	https://doi.org/10.1016/j.cardfail.2008.02.013
State	Published - Sep 2008

Keywords

Radial artery tonometry
biventricular pacing
echo Doppler
heart failure

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.cardfail.2008.02.013

Cite this

@article{611c608dd5a7467aa39a9faea20cf3b6,

title = "Echocardiography-Guided Pacemaker Optimization and Radial Artery Tonometry",

abstract = "Background: Biventricular (Biv) pacemaker optimization is underused because of time and echo skill required. We evaluated radial artery tonometry during echo-guided Biv optimization of atrioventricular (AV) and interventricular (VV) delays. Methods and Results: A total of 60 patients (67 ± 10 years) underwent simultaneous radial artery tonometry and echocardiography after Biv implant at baseline, short AV delay, and optimal AV delay. Twenty of these also underwent VV optimization. Optimal AV delay was determined by ejection duration (E-dur) of left ventricular (LV) outflow tract by pulsed-waved (PW) Doppler (LVE-dur) and mitral inflow PW Doppler pattern and optimal VV delay by LVE-dur and tissue Doppler. E-dur was also measured from radial artery pulse wave (RAE-dur). AV optimization improved LVE-dur from 249 ± 35 to 260 ± 38 ms (P < .01) and RAE-dur from 276 ± 31 ms to 284 ± 32 ms (P = .02). Correlation between LVE-dur and by RAE-dur was 0.83 (95% CI 0.75-0.92). RAE-dur was 282.53 ± 30 at baseline, 286.65 ± 36 at optimal AV delay (P < .04 vs. baseline) and 286.90 ± 35 ms (P < .04 vs. baseline) at optimal AV and VV delay in those who underwent VV optimization. Conclusions: AV and VV optimization by echocardiography produces significant improvement in LVE-dur and RAE-dur. Radial artery tonometry may provide a simple noninvasive method to assist in AV delay optimization.",

keywords = "Radial artery tonometry, biventricular pacing, echo Doppler, heart failure",

author = "Naqvi, {Tasneem Z.} and Rafique, {Asim M.}",

year = "2008",

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doi = "10.1016/j.cardfail.2008.02.013",

language = "English (US)",

volume = "14",

pages = "583--589",

journal = "Journal of Cardiac Failure",

issn = "1071-9164",

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T1 - Echocardiography-Guided Pacemaker Optimization and Radial Artery Tonometry

AU - Naqvi, Tasneem Z.

AU - Rafique, Asim M.

PY - 2008/9

Y1 - 2008/9

N2 - Background: Biventricular (Biv) pacemaker optimization is underused because of time and echo skill required. We evaluated radial artery tonometry during echo-guided Biv optimization of atrioventricular (AV) and interventricular (VV) delays. Methods and Results: A total of 60 patients (67 ± 10 years) underwent simultaneous radial artery tonometry and echocardiography after Biv implant at baseline, short AV delay, and optimal AV delay. Twenty of these also underwent VV optimization. Optimal AV delay was determined by ejection duration (E-dur) of left ventricular (LV) outflow tract by pulsed-waved (PW) Doppler (LVE-dur) and mitral inflow PW Doppler pattern and optimal VV delay by LVE-dur and tissue Doppler. E-dur was also measured from radial artery pulse wave (RAE-dur). AV optimization improved LVE-dur from 249 ± 35 to 260 ± 38 ms (P < .01) and RAE-dur from 276 ± 31 ms to 284 ± 32 ms (P = .02). Correlation between LVE-dur and by RAE-dur was 0.83 (95% CI 0.75-0.92). RAE-dur was 282.53 ± 30 at baseline, 286.65 ± 36 at optimal AV delay (P < .04 vs. baseline) and 286.90 ± 35 ms (P < .04 vs. baseline) at optimal AV and VV delay in those who underwent VV optimization. Conclusions: AV and VV optimization by echocardiography produces significant improvement in LVE-dur and RAE-dur. Radial artery tonometry may provide a simple noninvasive method to assist in AV delay optimization.

AB - Background: Biventricular (Biv) pacemaker optimization is underused because of time and echo skill required. We evaluated radial artery tonometry during echo-guided Biv optimization of atrioventricular (AV) and interventricular (VV) delays. Methods and Results: A total of 60 patients (67 ± 10 years) underwent simultaneous radial artery tonometry and echocardiography after Biv implant at baseline, short AV delay, and optimal AV delay. Twenty of these also underwent VV optimization. Optimal AV delay was determined by ejection duration (E-dur) of left ventricular (LV) outflow tract by pulsed-waved (PW) Doppler (LVE-dur) and mitral inflow PW Doppler pattern and optimal VV delay by LVE-dur and tissue Doppler. E-dur was also measured from radial artery pulse wave (RAE-dur). AV optimization improved LVE-dur from 249 ± 35 to 260 ± 38 ms (P < .01) and RAE-dur from 276 ± 31 ms to 284 ± 32 ms (P = .02). Correlation between LVE-dur and by RAE-dur was 0.83 (95% CI 0.75-0.92). RAE-dur was 282.53 ± 30 at baseline, 286.65 ± 36 at optimal AV delay (P < .04 vs. baseline) and 286.90 ± 35 ms (P < .04 vs. baseline) at optimal AV and VV delay in those who underwent VV optimization. Conclusions: AV and VV optimization by echocardiography produces significant improvement in LVE-dur and RAE-dur. Radial artery tonometry may provide a simple noninvasive method to assist in AV delay optimization.

KW - Radial artery tonometry

KW - biventricular pacing

KW - echo Doppler

KW - heart failure

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JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

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ER -

Echocardiography-Guided Pacemaker Optimization and Radial Artery Tonometry

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