Ultrasound cardiac output monitor versus conventional method for guiding pacemaker atrioventricular interval optimization in patients with atrioventricular block:a randomized controlled study
Ultrasound cardiac output monitor versus conventional method for guiding pacemaker atrioventricular interval optimization in patients with atrioventricular block:a randomized controlled study
Objective To evaluate the effectiveness and feasibility of ultrasound cardiac output monitoring(USCOM)in guiding atrioventricular interval(AVI)optimization in patients implanted pacemakers for atrioventricular block(AVB).Methods We conducted a randomized controlled study.A total of 95 patients with severe AVB and implanted with permanent dual-chamber pacemakers in Fuwai Yunnan Cardiovascular Hospital from November 2021 to December 2023 were included,and randomly divided into the USCOM-guided group(56 cases)and the conventional group(39 cases).Cardiac output(CO),cardiac index(CI),velocity time integral(VTI),stroke volume(SV),peripheral vascular resistance(SVR),and peripheral vascular resistance index(SVRI)were measured by USCOM in all enrollers and compared between two groups.Cardiac echocardiography parameters before AVI optimization and one month later were collected and compared between the two groups,including left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD).Results Compared to the conventional group,the USCOM-guided group had higher CO,CI,VTI and SV(Z=-4.194,-3.679,-3.618,and-4.548,respectively,all P＜0.001)and lower SVR and SVRI(Z=-3.363 and-2.587,respectively,both P＜0.05).The peak mitral late-diastolic inflow velocity was higher in the convetional group than in the USCOM-guided group.The optimal SAV/PAV in USCOM-guided group ranged from 90/120 ms to 300/330 ms.Most were at 180/210 ms(18 patients).Conclusions The USCOM-guided optimization for pacemaker AVI is safe,feasible,and effective,and improves short-term hemodynamics in AVB patients.
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