Houmsse Mahmoud, Abraham William T
The Ohio State University Wexner Medical Center - Cardiovascular Medicine, Heart and Lung Research Institute, 473 W. 12th Avenue Second floor, Columbus, OH 43235, USA.
Expert Rev Cardiovasc Ther. 2014 May;12(5):541-8. doi: 10.1586/14779072.2014.901150. Epub 2014 Mar 29.
Cardiac resynchronization therapy (CRT) is a well-established therapy to reduce morbidity and mortality in patients with moderate and severe symptomatic congestive heart failure. Left ventricular (LV) pacing that fuses with intrinsic right ventricular (RV) conduction results in similar or even better cardiac performance compared to biventricular (Biv) pacing. Optimal programming of the atrio-ventricular (AV) and inter-ventricular (VV) delays is crucial to improve LV performance since suboptimal programming of AV and VV delays affect LV filling as well as cardiac output. CRT optimization using echocardiogram is resource-dependent and time consuming. Adaptive CRT (aCRT) algorithm provides a dynamic, automatic, ambulatory adjustment of CRT pacing configuration (Biv or LV pacing) and optimization of AV and VV delays. aCRT algorithm is safe and efficacious for CRT-indicated patients without permanent atrial fibrillation. It has been shown to improve CRT response and reduce morbidity and mortality for patients with normal AV conduction.
心脏再同步治疗（CRT）是一种公认的疗法，可降低中重度症状性充血性心力衰竭患者的发病率和死亡率。与双心室（Biv）起搏相比，与固有右心室（RV）传导融合的左心室（LV）起搏可导致相似甚至更好的心脏功能。房室（AV）和心室间（VV）延迟的优化编程对于改善左心室功能至关重要，因为AV和VV延迟的编程不佳会影响左心室充盈以及心输出量。使用超声心动图进行CRT优化依赖资源且耗时。自适应CRT（aCRT）算法可对CRT起搏配置（Biv或LV起搏）进行动态、自动、动态调整，并优化AV和VV延迟。aCRT算法对于无永久性房颤的CRT适应证患者是安全有效的。已证明它可改善CRT反应，并降低正常AV传导患者的发病率和死亡率。
