{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T11:48:00Z","timestamp":1773056880685,"version":"3.50.1"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,2,6]]},"abstract":"\n Background<\/jats:title>\n \n QRS<\/jats:styled-content>\n narrowing following cardiac resynchronization therapy with biventricular (BiV) or left ventricular (LV) pacing is likely affected by patient\u2010specific conduction characteristics (\n PR<\/jats:styled-content>\n , qLV,\n LV<\/jats:styled-content>\n \u2010paced propagation interval), making a universal programming strategy likely ineffective. We tested these factors using a novel, device\u2010based algorithm (Sync\n AV<\/jats:styled-content>\n ) that automatically adjusts paced atrioventricular delay (default or programmable offset) according to intrinsic atrioventricular conduction.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Seventy\u2010five patients undergoing cardiac resynchronization therapy (age 66\u00b111\u00a0years; 65% male; 32% with ischemic cardiomyopathy; LV ejection fraction 28\u00b18%;\n QRS<\/jats:styled-content>\n duration 162\u00b116\u00a0ms) with intact atrioventricular conduction (PR interval 194\u00b134, range 128\u2013300\u00a0ms), left bundle branch block, and optimized\n LV<\/jats:styled-content>\n lead position were studied at implant.\n QRS<\/jats:styled-content>\n duration (\n QRS<\/jats:styled-content>\n d) reduction was compared for the following pacing configurations: nominal simultaneous BiV (Mode I: paced\/sensed atrioventricular delay=140\/110\u00a0ms), BiV+Sync\n AV<\/jats:styled-content>\n with 50\u00a0ms offset (Mode\n II<\/jats:styled-content>\n ), BiV+Sync\n AV<\/jats:styled-content>\n with offset that minimized\n QRS<\/jats:styled-content>\n d (Mode\n III<\/jats:styled-content>\n ), or\n LV<\/jats:styled-content>\n \u2010only pacing+Sync\n AV<\/jats:styled-content>\n with 50\u00a0ms offset (Mode\n IV<\/jats:styled-content>\n ). The intrinsic\n QRS<\/jats:styled-content>\n d (162\u00b116\u00a0ms) was reduced to 142\u00b117\u00a0ms (\u221211.8%) by Mode I, 136\u00b114\u00a0ms (\u221215.6%) by Mode\n IV<\/jats:styled-content>\n , and 132\u00b113\u00a0ms (\u221217.8%) by Mode\n II<\/jats:styled-content>\n . Mode\n III<\/jats:styled-content>\n yielded the shortest overall\n QRS<\/jats:styled-content>\n d (123\u00b112\u00a0ms, \u221223.9% [\n P<\/jats:italic>\n <0.001 versus all modes]) and was the only configuration without\n QRS<\/jats:styled-content>\n d prolongation in any patient.\n QRS<\/jats:styled-content>\n narrowing occurred regardless of\n QRS<\/jats:styled-content>\n d,\n PR<\/jats:styled-content>\n , or\n LV<\/jats:styled-content>\n \u2010paced intervals, or underlying ischemic disease.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Post\u2010implant electrical optimization in already well\u2010selected patients with left bundle branch block and optimized\n LV<\/jats:styled-content>\n lead position is facilitated by patient\u2010tailored BiV pacing adjusted to intrinsic atrioventricular timing using an automatic device\u2013based algorithm.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.007489","type":"journal-article","created":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T09:53:58Z","timestamp":1518083638000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":64,"title":["Programming Cardiac Resynchronization Therapy for Electrical Synchrony: Reaching Beyond Left Bundle Branch Block and Left Ventricular Activation Delay"],"prefix":"10.1161","volume":"7","author":[{"given":"Niraj","family":"Varma","sequence":"first","affiliation":[{"name":"Cleveland Clinic, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"Cardiology, Austin Health, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Bassiouny","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Ritter","sequence":"additional","affiliation":[{"name":"University Hospital of Bordeaux, Pessac, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Pappone","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Mangual","sequence":"additional","affiliation":[{"name":"Abbott, Sylmar, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Cantillon","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nima","family":"Badie","sequence":"additional","affiliation":[{"name":"Abbott, Sylmar, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Thibault","sequence":"additional","affiliation":[{"name":"Electrophysiology Service, Montreal Heart Institute, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Wisnoskey","sequence":"additional","affiliation":[{"name":"Abbott, Sylmar, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht290"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hfc.2016.07.019"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.11.025"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr329"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut206"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.12.006"},{"key":"e_1_3_2_8_2","first-page":"1077","article-title":"Clinical relevance of systematic CRT device optimization","volume":"7","author":"Lunati M","year":"2014","unstructured":"Lunati M, Magenta G, Cattafi G, Moreo A, Falaschi G, Contardi D, Locati E. 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