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A. Basics
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Early time to response in hemodynamic sensor guided cardiac resynchronization therapy
Session:
Posters 2 - Écran 04 - Arritmologia - Dispositivos
Speaker:
Ines Rodrigues
Congress:
CPC 2018
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.3 Cardiac Resynchronization Therapy
Session Type:
Posters
FP Number:
---
Authors:
Dra. Inês Rodrigues; Mário Martins Oliveira; Pedro Silva Cunha; Luisa Moura Branco; Ana Galrinho; Paulo Osório; Ana Lousinha; Bruno Tereno Valente; Guilherme Portugal; Joana Neiva; Rui Cruz Ferreira
Abstract
<p><strong>Background</strong>: The hemodynamic sensor-based cardiac resynchronization (CRT) optimization, which weekly adjusts atrioventricular (AV) and interventricular (VV) delays timings automatically according to individual cardiac contractility, had recently shown to improve clinical response and to reduce HF hospitalizations in CRT patients.</p> <p><strong>Aim:</strong> We investigated the rate of responders and time to echocardiographic response in heart failure (HF) patients undergoing CRT implantation with and without this sensor automatic-based optimization.</p> <p><strong>Methods</strong>: From a cohort of HF patients submitted to CRT in a single center, patients with a hemodynamic sensor system “on” were compared with a control-matched group (CRT without automatic optimization) based on age, gender, HF etiology and baseline left ventricular ejection fraction (LVEF). Transthoracic echocardiograms were performed before CRT (M0), and at 2 (M2) and 6 months (M6) after CRT. The evaluated parameters included LVEF, LV end-diastolic and end-systolic volumes (LVEDV, LVESV, respectively). Echocardiographic response was defined by an absolute increase of at least 10% in LVEF (↑ LVEF ≥ 10%). Patients with a two-fold or more increase of LVEF or a final LVEF>45% and a decrease in LVESV >15% were classified as super-responders. Rate and time to response was compared at M2 and M6 in both groups. Kaplan-Meier curves were generated to determine response rates.</p> <p><strong>Results</strong>: 40 patients (70% men, mean age 61±9 years, 30% ischemic HF, mean baseline LVEF 27±6%) were included in the analysis (with sensor-guided optimization – n=20; without automatic optimization – n=20). The rate of echocardiographic responders at 2M after CRT was similar in patients with and without automatic optimization (20±9%), but at 6M there was a tendency for a higher response rate in patients with automatic optimization (40±12% vs. 30±13%, p=0.485, figure), and also for earlier time to response (79±56 days vs. 103±73 days, p=0.386). The super-responders rate at 2M and 6M was also no statistically different in patients with and without sensor-guided optimization (2M - 10±8% vs. 10±7%; 6M - 21±10% vs. 15±8%; p=0.398).</p> <p><strong>Conclusions</strong>: This single center preliminary study had shown a tendency for earlier and higher revere remodeling rates in patients under automatic hemodynamic sensor-based CRT optimization. These findings need further confirmation with higher samples to increase statistical power and significance.</p>
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