{"id":"9dd1fc3047e1","type":"article","url":"https://hartvaat.nl/2017/05/01/automatische-pacing-timingaanpassingen-en-effectieve-lv-pacing-bij-crt/","title":"Automatische pacing-timingaanpassingen en effectieve LV-pacing bij CRT","title_en":"Influence of automatic frequent pace-timing adjustments on effective left ventricular pacing during cardiac resynchronization therapy.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["cardiale-resynchronisatie","linkerbundeltakpacing"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euw108","source_url":"https://doi.org/10.1093/europace/euw108","authors":["Niraj Varma","Robert W Stadler","Subham Ghosh","Axel Kloppe"],"significance":4,"published":"2017-05-01","source_date":"2017-05-01","image":"","kennis":[],"congress":"","summary_en":"This study evaluated the impact of the AdaptivCRT algorithm on effective left ventricular pacing by comparing morphological consistency of ventricular depolarisations and pacing percentage in CRT patients randomised to adaptive versus echo-optimised programming.","created":"2026-07-03T10:26:41Z","updated":"2026-07-03T13:25:59Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar de invloed van automatische pacing-timingaanpassingen op de effectieve linkerkamerpacing bij CRT. Technologische optimalisatie voor betere CRT-respons.","abstract_original":"AIMS: Cardiac resynchronization therapy (CRT) requires effective left ventricular (LV) pacing (i.e. sufficient energy and appropriate timing to capture). The AdaptivCRT™ (aCRT) algorithm serves to maintain ventricular fusion during LV or biventricular pacing. This function was tested by comparing the morphological consistency of ventricular depolarizations and percentage effective LV pacing in CRT patients randomized to aCRT vs. echo-optimization. METHODS AND RESULTS: Continuous recordings (≥20 h) of unipolar LV electrograms from aCRT (n = 38) and echo-optimized patients (n = 22) were analysed. Morphological consistency was determined by the correlation coefficient between each beat and a template beat. Effective LV pacing of paced beats was assessed by algorithmic analysis of negative initial EGM deflection in each evoked response. The %CRT pacing delivered, %effective LV pacing (i.e. % of paced beats with effective LV pacing), and overall %effective CRT (i.e. product of %CRT pacing and %effective LV pacing) were compared between aCRT and echo-optimized patients. Demographics were similar between groups. The mean correlation coefficient between individual beats and template was greater for aCRT (0.96 ± 0.03 vs. 0.91 ± 0.13, P = 0.07). Although %CRT pacing was similar for aCRT and echo-optimized (median 97.4 vs. 98.6%, P = 0.14), %effective LV pacing was larger for aCRT [99.6%, (99.1%, 99.9%) vs. 94.3%, (24.3%, 99.8%), P=0.03]. For aCRT vs. echo-optimized groups, the proportions of patients with ≥90% effective LV pacing was 92 vs. 55% (P = 0.002), and with ≥90% effective CRT was 79 vs. 45%, respectively (P = 0.018). CONCLUSION: AdaptivCRT™ significantly increased effective LV pacing over echo-optimized CRT."}