Predictors of stroke volume improvement with AV-optimized conduction system pacing in patients with AV dromotropathy

Zupan Mežnar, Anja (avtor), Žlahtič, Tadej (avtor), Mrak, Miha (avtor), Ivanovski, Maja (avtor), Žižek, David (avtor)

Aims: Patients with first-degree atrioventricular (AV) block and mechanical AV dyssynchrony can present with heart failure (HF)- like symptoms. AV-optimized conduction system pacing (CSP) can improve haemodynamics and symptoms, but selection criteria remain uncertain. We aimed to identify electrocardiographic and echocardiographic predictors of an acute haemodynamic response to AV-optimized CSP in symptomatic first-degree AV block. Methods and Results: Nineteen patients (mean age 60.5 ± 21.1 years; 37% female) with symptomatic first-degree AV block underwent baseline electrocardiography and echocardiography followed by AV-optimized conduction system pacing and repeat echocardiographic assessment. Electrocardiographic parameters (PR interval, P wave duration/PR interval ratio) and echocardiographic indices (E/A wave confluence, A-Q interval, and DFT/RR ratio) were tested for association with change in left ventricular stroke volume (LVSV). The mean PR interval was 395 ± 61 ms, the mean A-Q interval 155 ± 65 ms, and the mean DFT/RR ratio 0.34 ± 0.1. E/A wave confluence was present in 15 patients (79%). AV-optimized pacing increased LVSV by 7.8 ± 3.9 ml, corresponding to an 11.8 ± 5.7% relative increase (P < .01). Echocardiographic parameters were associated with LVSV response, including A-Q interval (r = 0.63, P = .004), DFT/RR ratio (r = −0.59, P = .008), and E/A wave confluence (r = 0.57, P = .01). Electrocardiographic parameters were not associated with LVSV change. Conclusions: Echocardiographically assessed mechanical AV dyssynchrony, rather than electrocardiographic parameters, is associated with an acute haemodynamic response to pacing. Echocardiographic evaluation may help identify patients with prolonged PR interval who could benefit from AV-optimized CSP.

• Jezik: Angleški jezik
• Ključne besede: atrioventricular dyssynchrony, atrioventricular conduction block, conduction system pacing, atrioventricular optimization
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.03 - Drugi znanstveni članki
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2026
• Št. strani: 3 str.
• Številčenje: Vol. 13, issue 2
• PID: 20.500.12556/RUL-186957
• UDK: 616.12
• ISSN pri članku: 2055-5822
• DOI: 10.1093/eschf/xvag060
• COBISS.SI-ID: 274303747
• Datum objave v RUL: 08.09.2026

Gradivo je del revije

• Naslov: ESC heart failure
• Založnik: Wiley & Sons
• ISSN: 2055-5822
• COBISS.SI-ID: 523661593

Licence

• Licenca: CC BY 4.0, Creative Commons Priznanje avtorstva 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by/4.0/deed.sl
• Opis: To je standardna licenca Creative Commons, ki daje uporabnikom največ možnosti za nadaljnjo uporabo dela, pri čemer morajo navesti avtorja.

Projekti

• Financer: University Medical Centre Ljubljana
• Številka projekta: TP20190093