{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T23:27:18Z","timestamp":1773098838687,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2009,3,19]],"date-time":"2009-03-19T00:00:00Z","timestamp":1237420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:p> <jats:italic>Background:<\/jats:italic> Chronotropic incompetence is common among patients with advanced heart failure (HF), thus atrial pacing (AP) is frequently utilized in this population. The hemodynamic effects of AP during cardiac resynchronization therapy (CRT) have not been well studied.<\/jats:p><jats:p> <jats:italic>Objective:<\/jats:italic> The purpose of this study was to compare the acute hemodynamic response during CRT of AP with that during atrial sensing (AS).<\/jats:p><jats:p> <jats:italic>Methods:<\/jats:italic> This study included 26 patients undergoing CRT. At implant, invasive left ventricular (LV) dP\/dt was measured by a micromanometer catheter during biventricular pacing in AS and AP modes at 5 different atrioventricluar delays (AVD), tested in randomized order. Postimplant, echocardiography was performed to obtain aortic and mitral flow velocity integrals at baseline (no CRT) and during CRT.<\/jats:p><jats:p> <jats:italic>Results:<\/jats:italic> Compared with intrinsic rhythm, CRT increased LV dP\/dt by 11 \u00b1 11% during AS (heart rate: 74 \u00b1 13 bpm) and by 17 \u00b1 11% during AP (heart rate: 86 \u00b1 12 bpm, P &lt; 0.001). The AVD associated with maximal hemodynamic response (AVD<jats:sub>max<\/jats:sub>) during AP was 72 \u00b1 40 ms longer than during AS. However, aortic and mitral flow velocity integrals decreased by 15\u201320% during AP. The aortic and mitral flow velocities at AVD<jats:sub>max<\/jats:sub> for LV dP\/dt<jats:sub>max<\/jats:sub> were highly correlated with their maximum values (r &gt; 0.98).<\/jats:p><jats:p> <jats:italic>Conclusion:<\/jats:italic> AP increases LV dP\/dt during CRT, but requires a substantially longer AV delay. However, AP results in modest reductions of LV filling and stoke volume. Further studies are needed to assess the long\u2010term impact of AP on HF functional status and LV remodeling.<\/jats:p>","DOI":"10.1111\/j.1540-8167.2009.01460.x","type":"journal-article","created":{"date-parts":[[2009,3,19]],"date-time":"2009-03-19T15:27:02Z","timestamp":1237476422000},"page":"894-900","source":"Crossref","is-referenced-by-count":22,"title":["Acute Hemodynamic Effects of Atrial Pacing with Cardiac Resynchronization Therapy"],"prefix":"10.1111","volume":"20","author":[{"given":"MICHAEL R.","family":"GOLD","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"IMRAN","family":"NIAZI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MICHAEL","family":"GIUDICI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ROBERT 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