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Heart failure

Smart-AV attempts to optimize CRT

Nature Reviews Cardiology volume 8, page 3 (2011)Cite this article

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The SMART-AV trial has found no benefit of programmed atrioventricular (AV) delay being optimized on the basis of echocardiography or an electrocardiographic algorithm (SmartDelay®, Cardiac Pacemakers, Inc., St Paul, MN, USA) in CRT. A fixed AV delay of 120 ms was found to be just as effective as the two optimized programs at improving LV geometry and functional measures in patients with heart failure.

“We chose to undertake this research because approximately 30–40% of NYHA class III–IV patients with heart failure indicated for CRT have a limited response to the therapy,” explains Dr Kenneth Ellenbogen, lead author on the report. “We sought to improve the therapy by focusing on how to best resynchronize the heart's upper and lower contractions by optimizing the AV delay.”

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ORIGINAL RESEARCH PAPER

  1. Ellenbogen, K. A. et al. Primary results from the SmartDelay Determined AV Optimization: a Comparison to Other AV Delay Methods Used in Cardiac Resynchronization Therapy (SMART-AV trial: a randomized trial comparing empirical, echocardiography-guided, and algorithmic atrioventricular delay programming in cardiac resynchronization therapy. Circulation doi:10.1161/CIRCULATIONAHA.110.992552

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Authors
  1. Bryony M. Mearns
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Mearns, B. Smart-AV attempts to optimize CRT. Nat Rev Cardiol 8, 3 (2011). https://doi.org/10.1038/nrcardio.2010.193

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