SMART-AV

SmartDelay determined AV Optimization: A Comparison of AV Optimization Methods Used in Cardiac Resynchronization Therapy (SMART-AV)

Status: Completed in 2010

SMART-AV is the first large-scale trial to compare methods of optimizing AV delay, evaluate if more frequent re-optimization can improve clinical outcomes, and assess whether acute benefits translate into chronic benefits.


Results

  • The change in LVESV for the SmartDelay arm was no different than echocardiographic determined AV interval optimization as well as a Fixed AV delay of 120ms.
  • Echo was not superior to a fixed AV delay.

For additional information, please see the manuscript published in Circulation

Design

Patient Population

  • Eligible study participants included both male and female patients over 18 years of age whose disease state at the time of enrollment met indications for CRT-D therapy.
  • 1060 patients were enrolled at 100 sites across the United States and Europe. 

Clinical Relevance

  • To assess the chronic effects of three methods for determining AV delay timing during CRT: EGM optimization, echo optimization, and fixed
  • Primary Endpoint: LVESV
  • Secondary endpoints include: 6-minute walk, NYHA Class, and QOL
  • SMART-AV is the first large scale trial to compare methods of optimizing AV delay, evaluate if more frequent re-optimization can improve clinical outcomes, and assess whether acute benefits translate into chronic benefits. 

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