Determination of optimal atrioventricular delay for cardiac resynchronization therapy using acute non-invasive blood pressure

Abstract

Aims In this study, we apply non-invasive blood pressure (BP) monitoring, by continuous finger photoplethysmography (Finometer), to detect directly haemodynamic responses during adjustment of the atrioventricular (AV) delay of cardiac resynchronization therapy (CRT), at different heart rates. Methods and results Twelve patients were studied with six re-attending for reproducibility assessment. At each AV delay, systolic BP relative to a reference AV delay of 120 ms (SBP_rel) was calculated. We found that at higher heart rates, altering the AV delay had a more pronounced effect on BP (average range of SBP_rel=17.4 mmHg) compared with resting rates (average range of SBP_rel=6.5 mmHg), Prel by 4.9 mmHg (Prel by 4.4 mmHg (PConclusions Continuous non-invasive arterial pressure monitoring demonstrates that even small changes in AV delay from its haemodynamic peak value have a significant effect on BP. This peak varies between individuals, is highly reproducible, and is more pronounced at higher heart rates than resting rates.