The Effect of Cardiac Resynchronizing Therapy on the Parameters of Mechanical Dyssynchrony in Patients with Chronic Heart Failure Complicated by Atrial Fibrillation - The 65th Annual Conference of the Israel Heart Society & The Israel Society of Cardiothoracic Surgery, 24-25 April 2018

Tatyana Troyanova-Shchutskaia Heart failure department, Republican Scientific and Practical center of Cardiology, Minsk, Belarus Alena Kurlianskaya Heart failure department, Republican Scientific and Practical center of Cardiology, Minsk, Belarus Tatyana Denisevich Heart failure department, Republican Scientific and Practical center of Cardiology, Minsk, Belarus Dmitry Goncharik Heart failure department, Republican Scientific and Practical center of Cardiology, Minsk, Belarus Aleksandr Chasnoyt Heart failure department, Republican Scientific and Practical center of Cardiology, Minsk, Belarus

Introduction:

The questions concerning to the mechanical dissynchrony and its changing through cardiac resynchronization therapy (CRT) remain despite the development of the method.

Aim:

to study the effect of СRT on myocardial dissynchrony.

Material and methods:

The effectiveness of СRT was assessed in groups of patients with atrial fibrillation (AF) (group 1, n = 50) and sinus rhythm (SR) (group 2, n = 29). Patients with AF had ablation of the atrioventricular node. Examination included echocardiography and was performed at baseline and in 12 months after CRT.

Results. The presystolic aortic delay was significantly higher in group 1, the delay in the pulmonary artery valve was higher in group 2. There were no significant differences in interventricular delay (p=0.068). Intergroup differences in septal posterior delay (p<0.001) and maximum basal delay (p=0.039) were noted. In 12 months after CRT in group 1 a decrease in presystolic aortic delay to 148 (139, 164) ms (p = 0.038), intraventricular delay (up to 25 (13; 33) ms, p<0.001) was revealed. In group 2 the positive dynamics was noted by the time of presystolic delay on the pulmonary artery valve (up to 118 (100; 143) ms, p=0.004) and intraventricular dissynchrony.(up to 28 (19; 35) ms, p<0.001). The differences in the time groups for presystolic delay on the pulmonary artery valve (p=0.506) and maximum basal delay (p=0.897) were leveled. Presystolic aortic delay was higher in group 1 (p=0.011).

Conclusions:

There are specific features of mechanical dissynchrony in patients with AF and SR at baseline. CRT in patients with AF is characterized by a reduction in presystolic aortic delay. In patients with SR the reduction in presystolic delay in the pulmonary artery valve was revealed after interventional treatment. In all patients CRT had an effect on the severity of intraventricular dissynchrony.