OPTIMIZATION OF THE ATRIOVENTRICULAR DELAY IN SEQUENTIAL AND BIVENTRICULAR PACING: PHYSIOLOGICAL BASES, CRITICAL REVIEW, AND NEW PURPOSES

Department of Cardiology, San Filippo Neri Hospital, Rome, Italy

Atrioventricular (AV) delay optimization in sequential and biventricular (BiV) pacing is crucial for effective cardiac stimulation, yet it is often inadequately performed in clinical settings. The manuscript outlines the physiological principles behind AV delay optimization and categorizes existing programming methods into predefined formulas, iterative attempts, and automatic settings. It emphasizes the need for individualized approaches based on patient-specific variables and discusses the implications of these methods on clinical outcomes. The authors propose new strategies aimed at enhancing the effectiveness of BiV pacing.