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
• Design
• Patient Population
• Clinical Relevance

Results¹

• 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.