Details

Autor(en) / Beteiligte

• Pereferrer, Damia
• Sarrias, Axel
• Adeliño, Raquel
• Bisbal, Felipe
• Aranyó, Júlia
• Vallejo, Nuria
• Villuendas, Roger
• Bayes-Genis, Antoni
• Bazan, Victor

Titel

Inefficient diastolic filling in dual-chamber pacemaker recipients: impact of atrio-ventricular interval shortening (AVI-SHORT study)

Ist Teil von

• Journal of interventional cardiac electrophysiology, 2023-04, Vol.66 (3), p.683-691

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2023

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Adequate synchronization between the passive (“E”) and active (“a”) left ventricular (LV) diastolic filling contributes to the efficiency of the heartbeat. E/a superposition in dual-chamber pacemaker (PM) recipients is an under-recognized phenomenon that may be corrected by shortening the atrio-ventricular interval (AVI). We aimed at establishing the prevalence of E/a superposition in PM patients and to analyze the clinical, echocardiographic, and biological impact of AVI shortening. Methods Seventy patients with dual-chamber PMs (74 ± 8 years old, 12 women) were consecutively enrolled in this study. Patients with baseline E/a superposition were crossed over from default to manually shortened AVI or vice versa in a case–control fashion (intervention group). Patients without baseline E/a superposition (controls) served as a reference for a descriptive comparison with the intervention group. Results Thirty-three patients had E/a superposition after PM implantation (47%). Controls ( n  = 37) had higher LV ejection fraction (59 ± 8% vs. 53 ± 10%, p  = 0.048) and lower levels of high sensitive troponin T and ST2 ( p  < 0.05) than intervention group patients. The AVI was shortened at 48 ± 9 ms in order to ensure adequate E/a separation. The walked distance increased from 75 ± 17 to 78 ± 10% ( p  = 0.049) and the Euro-QoL score from 0.50 ± 0.27 to 0.63 ± 0.19 ( p  = 0.011) with short AVI. Conclusions E/a superposition occurs in approximately half of dual-chamber PM recipients and is associated with reduced LV function and increased myocardial injury biomarkers. AVI shortening produces a modest but significant effect in functional capacity and quality of life.