{"id":809,"date":"2025-07-31T14:23:40","date_gmt":"2025-07-31T14:23:40","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=809"},"modified":"2025-11-13T12:14:44","modified_gmt":"2025-11-13T12:14:44","slug":"optimisation-des-delais-av-vv-microport","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/microport-crm\/av-vv-delay-optimization-microport\/","title":{"rendered":"Optimisation du d\u00e9lai AV et VV \u2013 Microport"},"content":{"rendered":"\t\t

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Microport - AV & VV delays optimization<\/h1>\t\t\t\t<\/div>\n\t\t\t\t
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The sensor for AV & VV delay optimization<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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The SonR^{\u00ae<\/sup>\u00a0micro-accelerometer hemodynamic sensor is enclosed in a sealed capsule at the tip of an atrial pacing lead (IS-1 compatible SonRtip lead).<\/p>}
The sensor measures in g (m\/s^{2<\/sup>) the myocardial micro-accelerations throughout the cardiac cycle; SonR1, one of its main components, is created by the iso-volumic contraction.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t}
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The SonR1 component of this signal corresponds to the first heart sound S1. Its variations are correlated to the variations in LV_{\u00a0max<\/sub>dP\/dt.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t}
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The SonR CRT-D systems digitize and analyze the SonR1 signal originating from the atrial lead. The algorithm contained in these defibrillators automatically optimizes the AV and VV delays on a weekly basis.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
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The SonR optimization, carried out in the night of Sunday to Monday, is an automatic weekly test of 69 combinations of AV\/VV delays. Each combination of AV\/VV delays is adjusted in a sequence of 3 adaptive cycles followed by 6 cycles to measure the SonR.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
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Tests for AV & VV delay optimization<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Test of VV\u00a0delay optimization: Monday at midnight:<\/strong><\/p>
Seven BiV configurations are tested (from LV \u00e0 RV 48 ms to RV \u00e0 LV 48 ms; in 16 ms steps) using 6 different AV delays, from 30 ms to spontaneous conduction minus 50 ms.<\/p>
This test includes 42 combinations and 252 SonR measurements.<\/p>
Test of AV\u00a0delay optimization at rest: Monday \u00e0 01:00h:<\/strong><\/p>
After optimization of the VV delay, 11 different AV delays, from 30 ms to spontaneous conduction minus 50 ms are tested. This test includes 11 combinations and 66 SonR measurements.<\/p>
Test of paced AV\u00a0delay optimization: Monday at 02:00h:<\/strong><\/p>
After optimization of the VV delay, 11 different AV delays, from 30 ms to spontaneous conduction minus 50 ms, are tested. This test includes 11 combinations and 66 SonR measurements.<\/p>
Test of AV\u00a0delay optimization during exercise: from Monday at 12:00h:<\/strong><\/p>
Optimization of the AV delay during exercise starts as soon as the heart rate has reached a programmed value. After optimization of the VV delay, 5 different AV delays, from 30 ms to spontaneous conduction during exercise minus 50 ms, are tested. This test includes 5 combinations and 30 SonR measurements.<\/p>
Condition of implementation of AV delays or optimized VV delays:<\/strong><\/p>
A new VV delay is implemented only after a \u2265 14% increase in SonR1. If the new optimal VV delay differs from the previous VV delay by > 16 ms, the VV delay is progressively increased in 16 ms steps until this new optimal VV delay has been reached.<\/p>
The variation in AV delay is systematically limited to 20 ms. The ranges are:<\/p>
Sensed AV delay at rest = [60-180 ms]<\/li>
Paced AV delay at rest = [92-240 ms]<\/li><\/ul>
Manual test<\/strong><\/p>
Tests of AV\/ VV delays optimization can also be performed during the patient follow-up, including with the LV only configuration.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
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Memorized data<\/strong><\/p>
The average amplitude of the SonR signal and the adaptation of the AV and VV delays optimized weekly are available in the memories of the SonR CRT-D.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
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The SonR signal is also recorded during episodes of tachyarrhythmia in order to examine the immediate changes in cardiac contractility and evaluate the hemodynamic tolerance of an arrhythmia.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
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Fall in the amplitude of the SonR signal at the time of non-sustained ventricular tachycardia<\/strong><\/p>
The SonR CRT-D can also transmit real-time SonR signals by telemetry.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
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Real-time inspection of SonR signal\u00a0<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
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Discover relevant cases<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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