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Lower percentage of bi-ventricularly paced beats (%VP) is associated with a higher mortality in Cardiac Resynchronization Therapy (CRT) patients. Modern CRT devices provide algorithms to increase %VP, such as Ventricular Sense Response (VSR), Conducted Atrial Fibrillation Response (CAFR) and Atrial Tracking Recovery (ATR). We aimed to determine if utilization of these three algorithms was associated with increased %VP.
We analyzed device diagnostics transmitted from 76,955 CRT-D recipients into the CareLink (Medtronic Inc.) database between 2005 and 2012. Patients in whom CRT pacing was intentionally programmed OFF were excluded. Mean %VP over the device life-time and proportion of patients with %VP <90% were compared between patients with the algorithms programmed ON vs. OFF. The comparison was also done by Atrial Fibrillation (AF) burden, determined from the device diagnostics.
Patients with the algorithms ON had higher %VP than those who had all algorithms OFF (Table). Proportion of patients with %VP<90% was 9.9% and 18.3% (p<0.001) with the algorithms ON and OFF respectively. The difference in %VP was observed mainly in patients with No/Little or Paroxysmal AF and was primarily due to the operation CAFR and VSR algorithms.
Utilizing CRT pacing algorithms was associated with an increase in %VP and reduction in the proportion of patients with %VP<90% for patients with No/Little or Paroxysmal AF.
|(Mean ± SD||(Mean ± SD)||(t-test)|
|patients with or w/o AF||± 6.0||± 11.5||0.001|
|AF||± 4.9||± 11.4||0.001|
|AF||± 4.9||± 12.0||0.001|
|AF||± 7.9||± 11.4|
|AF||± 10.2||± 10.5|
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Insights into Cardiac Resynchronization and Device Therapies in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1219M-268
- 2013 American College of Cardiology Foundation