Effect Of Periodic Pacemaker Optimization On Left Atrial Reverse Remodeling In Long-term Cardiac Resynchronization Therapy

Objective:Few data exist about the effect of cardiac resynchronization therapy (CRT) on left atrial (LA) reverse remodeling and function, and whether echocardiographic(echo)-guide pacemaker optimization of atrioventricular and interventricular delays could beneficially affect LA reverse remodeling in long-term CRT therapy.Methods:Effect of periodic pacemaker optimization on LA reverse remodeling induced by CRT was analyzed in113consecutive patients (mean age60±11y), and stratified according to periodic pacemaker optimization (Group1) and non-periodic pacemaker optimization (Group2). LAVI percent changes were assessed at every continuing6-month follow-up visit. The primary endpoint was LA reverse remodeling. The secondary endpoint included left ventricular reverse remodeling and left ventricular ejection fraction.Results:There is no significant difference of follow-up duration in subgroups (42.43±18.94months in Group1VS37.76±20.24months in Group2, P=0.228). The responder’s rate of subgroups showed similar after follow-up of12months (60.0%VS53.2%, P=0.483). After24-month follow-up of the mean reduction of LAV index was similar in two groups (10.34%VS7.53%, P=0.257). The improvement effect of LA reverse remodeling induced by CRT was sustained during24-month follow-up to the end of current study in periodic pacemaker optimization group. The degree of LAV index percent reduction was directly correlated to periodic pacemaker optimization at end of current analysis (17.13%VS10.35%, P=0.047).Conclusions:Periodic echo-guide pacemaker optimization of atrioventricular and interventricular delays plays a positive role on LA reverse remodeling in long-term CRT therapy.