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41 Correlation and Reproducibility of Invasive and Non-invasive Haemodynamic Parameters for Identifying Optimal AV Delay in Cardiac Resynchronisation Therapy
  1. Judith Finegold1,
  2. Pierre Bordachar2,
  3. Andreas Kyriacou1,
  4. SM Afzal Sohaib1,
  5. Prapa Kanagaratnam3,
  6. Sylvain Ploux2,
  7. Boon Lim3,
  8. Nicholas Peters3,
  9. David Wyn Davies3,
  10. David Lefroy3,
  11. Philippe Ritter2,
  12. Darrel Francis1,
  13. Zachary Whinnett1
  1. 1International Centre for Circulatory Health, National Heart and Lung Institute
  2. 2Hôpital Du Haut-Lévêque
  3. 3Imperial College

Abstract

Background Acute haemodynamic measurements can be used for AV delay (AVD) optimisation of cardiac resynchronisation therapy (CRT). It is uncertain whether non-invasive measurements are as reliable as those measured invasively.

Methods 37 patients with CRT-P or CRT-D device (86% male, mean age 64 years) had AVD optimisation performed using both invasive and non-invasive systolic blood pressure (SBP) and LV dp/dtmax

Results There was good concordance between optima obtained using non-invasive SBP, invasive LV and aortic SBP: SDD between 5.7 and 14.1 ms, R2 between 0.86 and 0.95 (Table 1). In contrast, the optima derived from maximising LV dp/dtmax did not agree as well with the other optima: SDD between 28.1 and 29.8 ms, R2 between 0.58 and 0.65. Of the comparisons in all 36 patients, those between LV dp/dtmax and non-invasive SBP (r2 = 0.58) and between LV dp/dtmax and invasive LV SBP (r2 = 0.62) were worse (p = 0.0067 and 0.013 respectively) than the comparison between non-invasive SBP and invasive LV SBP (r2 = 0.88). Test re-test reproducibility was better for invasive and non-invasive SBP; invasive LV SBP (SDD 16.8ms, coefficient of variation COV 10.1) non-invasive SBP (SDD 18.3, COV 11.3), compared to invasive LV dp/dtmax (SDD 23.6, COV 14.6).

Abstract 41 Table 1

Comparison of AV optima determined using nvasive and non-invasive haemodynamic variables

Conclusions In this study, we demonstrate good agreement between AVD optimisation performed using non-invasive and invasive systolic blood pressure. LV dp/dtmax showed relatively poor correlation with the AVD optima determined using SBP which is most likely due to a larger noise component in LV dp/dtmax measurements.

  • Cardiac resynchronisation therapy
  • AV delay optimisation
  • Haemodynamics

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