Finapres systems are used to easily and non-invasively optimize the atrioventricular delay in cardiac resynchronization therapy (CRT). The changes in systolic blood pressure are monitored as atrioventricular (AV) delays are changed. By increasing AV delay from 40ms to 320ms initially the blood pressure will increase. Increasing AV delay beyond its optimum value will cause blood pressure to drop again. Non-invasive hemodynamic evaluation prevents cumbersome and lengthy ultrasound measurements or invasive blood pressure measurements.
Currently, pacemaker optimization in light of cardiac resynchronisation therapy frequently relies on cardiac ultrasound measurements. The use of ultrasound requires a skilled operator and can encompass a lengthy procedure as imaging the heart consistently in a reproducible way is a true art. And despite the best efforts of the operator, biological variation will still hamper sound pacemaker adjustments.
Whether or not the pacemaker adjustment (following hemodynamic evaluation in relation to pacemaker settings) improves cardiac resynchronisation depends on biological and observer variability, amongst others. With the CRT TrueMax application on Finapres Nova, lengthy procedures and influence of biological variation are a thing of the past: