Cardiac Resynchronization Therapy and AV Optimization: A Hemodynamic Evaluation with Non-Invasive Techniques

Aim: This study aimed to evaluate the impact of atrioventricular (AV) optimization of biventricular pacemakers on cardiac hemodynamic parameters, particularly mitral inflow and aortic valve velocity-time integral (VTI), using impedance cardiography (ICG) and echocardiography in patients with symptomatic systolic heart failure and left bundle branch block unresponsive to cardiac resynchronization therapy.Material and Methods: The study included 20 patients, 10 (50%) males and 10 (50%) females, aged between 18 and 80 years, who had undergone biventricular pacemaker implantation and did not have aortic stenosis, decompensated heart failure, or echocardiographically optimized AV interval measurements. Hemodynamic values were calculated following ICG measurements.Results: The mean AV delay time did not change after AV optimization (p=0.685). However, optimization led to a statistically significant increase in mitral inflow VTI and aortic valve VTI (both p