Acute Effects of Multisite Left Ventricular Pacing on Mechanical Dyssynchrony in Patients Receiving Cardiac Resynchronization Therapy

Rinaldi, Christopher Aldo; Kranig, Wolfgang; Leclercq, Christophe; Kacet, Salem; Betts, Timothy R.; Bordachar, Pierre; Gutleben, Klaus; Shetty, Anoop; Keel, Allen; Ryu, Kyungmoo; Farazi, Taraneh G.; Simon, Marcus; Naqvi, Tasneem Z.

doi:10.1016/j.cardfail.2013.10.003

Cited by 53 publications

(32 citation statements)

References 19 publications

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“…6,7 Multipoint left ventricular (LV) pacing in a single coronary sinus (CS) branch (MultiPoint™ Pacing [MPP], St. Jude Medical, Sylmar, CA) from a quadripolar LV lead is 1 strategy to improve CRT response. 8 Initial experience has shown that MPP provides acute benefit to LV dP/dt Max , 9 LV dyssynchrony, 10 LV peak radial strain, 11 LV systolic and diastolic pressure-volume (PV) loop parameters, 12 LV electrical activation, 13 and improves LV function at 3 months. 14 However, the long-term effects of MPP remain unknown.…”

Section: Introductionmentioning

confidence: 98%

Improving cardiac resynchronization therapy response with multipoint left ventricular pacing: Twelve-month follow-up study

et al. 2015

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Section: Introductionmentioning

confidence: 98%

Improving cardiac resynchronization therapy response with multipoint left ventricular pacing: Twelve-month follow-up study

et al. 2015

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“…An early feasibility study utilizing pressure wire measurements by Thibault et al in 21 patients showed an increase in LV dP/dt Max with MPP compared with simultaneous biventricular pacing. 9 In a multicentre study using tissue Doppler imaging and speckle tracking echocardiography, Rinaldi et al demonstrated an improvement in acute mechanical LV dyssynchrony 11 and in acute global peak LV radial strain 12 during delivery of MPP. A recent study of 15 patients compared MPP in a single CS branch with multisite LV pacing with two leads in two different CS branches and found no difference in acute LV dP/dt Max improvement between the two dual LV pacing modalities, which both offered significant improvement over baseline pacing.…”

Section: Multipointmentioning

confidence: 99%

“…TM Pacing delivered through a quadripolar LV lead has thus far been shown to provide acute benefit as measured by LV dP/dt Max , 9 LV dyssynchrony, 11 LV peak radial strain, 12 LV PV loop parameters, 10 and LV electrical activation. 19 Additionally, our recent work has suggested mid-term improvement in LV reverse remodelling and LV function with MPP over conventional CRT.…”

Section: Multipointmentioning

confidence: 99%

“…6,7 Multipoint left ventricular (LV) pacing [MultiPoint TM Pacing (MPP), St. Jude Medical, Sylmar, CA, USA] is a new CRT modality that enables sequential pacing from two LV sites (LV1 and LV2) through a quadripolar LV lead and from one right ventricular (RV) site. 8 MultiPoint TM Pacing provides benefit to acute LV haemodynamics, 9,10 dyssynchrony, 11 and peak radial strain 12 and to mid-term LV function 13 beyond conventional CRT. Previous studies have focussed on the acute and chronic benefits of MPP in patients receiving de novo CRT systems.…”

Section: Introductionmentioning

confidence: 99%

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Multipoint left ventricular pacing provides additional echocardiographic benefit to responders and non-responders to conventional cardiac resynchronization therapy

Pappone

Ćalović

Cuko

et al. 2015

European Heart Journal Supplements

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Cardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing [MultiPoint TM Pacing (MPP), St. Jude Medical, Sylmar, CA, USA] improves LV function and clinical response relative to conventional CRT in patients receiving a de novo device implant. We hypothesized that patients with a previously implanted conventional CRT device would receive additional benefit by switching to MPP. Patients receiving a CRT implant (Unify Quadra MP TM or Quadra Assura MP TM CRT-D and Quartet TM LV lead, St. Jude Medical) were programmed to conventional CRT (i.e. biventricular pacing with right ventricular and single LV sites) optimized by intraoperative haemodynamic measurements. After 12 months of conventional therapy, patients were reprogrammed to MPP and reevaluated at 16 months post-implant. Response to CRTwas prospectively defined as reduction in end-systolic volume (ESV) of ≥15% relative to baseline as determined by a blinded observer. Eight patients with an implanted CRT device [New York Heart Association III, ejection fraction (EF) 30 + 5%, QRS 149 + 18 ms] received 12 months of conventional CRTand were switched to MPP. After 12 months of conventional CRT, ESV reduction and EF increase relative to baseline were 218 + 12 and +5 + 4%, respectively, and six of eight (75%) patients were considered CRTresponders. After 4 months of MPP, two of two (100%) patients classified as non-responders to conventional CRT became responders with additional reduction in ESV of 233 and 220% and improvement in EF of +15 and +4%. The remaining six patients classified as responders experienced additional reduction in ESVof 213 + 21% and improvement in EF of +7 + 7% after switching to MPP. Multipoint LV pacing may provide additional improvement to LV function in patients receiving conventional CRT.

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“…As previously discussed, numerous studies have demonstrated the acute and mid-term benefits of MultiPoint pacing in improving electrical propagation, acute haemodynamics and dyssynchrony. [25][26][27][28][35][36][37] anatomical spacing between LV1 and LV2 cathodes resulted in the best dP/dt response more often than an electrical delay-based selection method. Moreover, pacing with 5 ms LV1-LV2 delay produced the best dP/dt response more often than pacing with 40 ms LV1-LV2.…”

mentioning

confidence: 99%

Optimisation of Cardiac Resynchronisation Therapy with MultiPoint™ Pacing

Curnis¹,

O’Donnell²,

Kloppe³

et al. 2015

Arrhythmia &Amp; Electrophysiology Review

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Cardiac resynchronisation therapy (CRT) using biventricular pacing is an established therapy for impairment of left ventricular (LV) systolic function in patients with heart failure (HF). Although technological advances have improved outcomes in patients undergoing biventricular pacing, the optimal placement of pacing leads remains challenging, and approximately one third of patients have no response to CRT. This may be due to patient selection and lead placement. Electrical mapping can greatly improve outcomes in CRT and increase the number of patients who derive benefit from the procedure. MultiPoint™ pacing (St Jude Medical, St Paul, MN, US) using a quadripolar lead increases the possibility of finding the best pacing site. In clinical studies, use of MultiPoint pacing in HF patients undergoing CRT has been associated with haemodynamic and clinical benefits compared with conventional biventricular pacing, and these benefits have been sustained at 12 months. This article describes the proceedings of a satellite symposium held at the European Heart Rhythm Association (EHRA) Europace conference held in Milan, Italy, in June 2015.

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Acute Effects of Multisite Left Ventricular Pacing on Mechanical Dyssynchrony in Patients Receiving Cardiac Resynchronization Therapy

Cited by 53 publications

References 19 publications

Improving cardiac resynchronization therapy response with multipoint left ventricular pacing: Twelve-month follow-up study

Improving cardiac resynchronization therapy response with multipoint left ventricular pacing: Twelve-month follow-up study

Multipoint left ventricular pacing provides additional echocardiographic benefit to responders and non-responders to conventional cardiac resynchronization therapy

Optimisation of Cardiac Resynchronisation Therapy with MultiPoint™ Pacing

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