Inadvertent QRS prolongation by an optimization device-based algorithm in patients with cardiac resynchronization therapy

Kamil Sedláček, Rostislav Polášek, Helena Jansová, Domenico Grieco, Pavel Kučera, Josef Kautzner, Darrel P Francis and Dan Wichterle

PLOS ONE, 2022, vol. 17, issue 9, 1-12

Abstract: Background: Device-based algorithms offer the potential for automated optimization of cardiac resynchronization therapy (CRT), but the process for accepting them into clinical use is currently still ad-hoc, rather than based on pre-clinical and clinical testing of specific features of validity. We investigated how the QuickOpt-guided VV delay (VVD) programming performs against the clinical and engineering heuristic of QRS complex shortening by CRT. Methods: A prospective, 2-center study enrolled 37 consecutive patients with CRT. QRS complex duration (QRSd) was assessed during intrinsic atrioventricular conduction, synchronous biventricular pacing, and biventricular pacing with QuickOpt-proposed VVD. The measurements were done manually by electronic calipers in signal-averaged and magnified 12-lead QRS complexes. Results: Native QRSd was 174 ± 22 ms. Biventricular pacing with empiric AVD and synchronous VVD resulted in QRSd 156 ± 20 ms, a significant narrowing from the baseline QRSd by 17 ± 27 ms, P = 0.0003. In 36 of 37 patients, the QuickOpt algorithm recommended left ventricular preexcitation with VVD of 42 ± 18 ms (median 40 ms; interquartile range 30–55 ms, P

Date: 2022
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0275276

DOI: 10.1371/journal.pone.0275276

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