Ivcd 3.3.3 trial#
The MUSTIC trial 18 is a single-blind, randomized, controlled, crossover study, with patients recruited from 15 European centres. We therefore used echocardiography to correlate the haemodynamic effects of A-BiV pacing with changes in cavity size and exercise tolerance up to 12 months after the onset of pacing in a sub-study of patients participating in the MUSTIC study. However, the mechanisms by which A-BiV pacing improves mechanical LV function and exercise tolerance in the medium term are complex and not well understood. Short-term studies using atrio-biventricular (A-BiV) pacing in patients with severe congestive heart failure and IVCD report haemodynamic improvement by altering the ventricular activation sequence, 10–17 and recent results from the MUSTIC trial 18 suggest A-BiV pacing significantly improves exercise tolerance and quality of life in such patients. 9 Biventricular pacing has been proposed as a means of altering the electrical activation sequence in patients with heart failure and IVCD, with the aim of restoring synchronous LV contraction.
7,8 These effects become more marked during dobutamine stress. Septal minor and long axis contraction are delayed, 4,5 time to maximum rate of rise of ventricular pressure is prolonged, and the duration of mitral regurgitation 6 and isovolumic periods are increased, so that diastolic filling time at rest is reduced. Intra-ventricular conduction delay (IVCD) is common in patients with severe heart failure 1–3 and causes left ventricular (LV) asynchrony.
Ivcd 3.3.3 mac#
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Ivcd 3.3.3 free#
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Ivcd 3.3.3 for mac#
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