Acute changes in electromechanical parameters during different pacing configurations using a quadripolar left ventricular lead

Valzania, Cinzia; Eriksson, Maria; Biffi, Mauro; Boriani, Giuseppe; Gadler, Fredrik

doi:10.1007/s10840-013-9812-8

Cited by 10 publications

(4 citation statements)

References 31 publications

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“…Several studies have also shown changes in LV electrical activation with a quadripolar lead. 61,62 The next logical question is whether MSP using multipolar pacing configurations can improve CRT response. To address this important question, we only have preliminary data from small acute studies (Table 1) and this type of pacing should still be considered experimental, with only preliminary results.…”

Section: Multipolar Leads and Cardiac Resynchronization Therapymentioning

confidence: 99%

A review of multisite pacing to achieve cardiac resynchronization therapy

et al. 2014

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Non-response to cardiac resynchronization therapy remains a significant problem in up to 30% of patients. Multisite stimulation has emerged as a way of potentially overcoming non-response. This may be achieved by the use of multiple leads placed within the coronary sinus and its tributaries (dual-vein pacing) or more recently by the use of multipolar (quadripolar) left ventricular pacing leads which can deliver pacing stimuli at multiple sites within the same vein. This review covers the role of multisite pacing including the interaction with the underlying pathophysiology, the current and planned studies, and the potential pitfalls of this technology.

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Section: Multipolar Leads and Cardiac Resynchronization Therapymentioning

confidence: 99%

A review of multisite pacing to achieve cardiac resynchronization therapy

et al. 2014

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“…This is especially true when resynchronization does not just involve apical segments, but also basal and mid-LV portions for a global effect [ 39 ]. Indeed, in CRT patients receiving an LV lead with multiple selectable electrodes (a quadripolar LV lead), the simultaneous recruitment of a wider portion of LV myocardium is associated with an acute electromechanical improvement [ 40 , 41 , 42 ]. However, in ischemic patients, the benefits of CRT on FMR may be limited in those with significant scar burden because the activation site may not be able to contribute to LV contractility.…”

Section: The Rationale Of Crtmentioning

confidence: 99%

The Role of Cardiac Resynchronization Therapy for the Management of Functional Mitral Regurgitation

Russo

Cassese

et al. 2022

Cells

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Valve leaflets and chordae structurally normal characterize functional mitral regurgitation (FMR), which in heart failure (HF) setting results from an imbalance between closing and tethering forces secondary to alterations in the left ventricle (LV) and left atrium geometry. In this context, FMR impacts the quality of life and increases mortality. Despite multiple medical and surgical attempts to treat FMR, to date, there is no univocal treatment for many patients. The pathophysiology of FMR is highly complex and involves several underlying mechanisms. Left ventricle dyssynchrony may contribute to FMR onset and worsening and represents an important target for FMR management. In this article, we discuss the mechanisms of FMR and review the potential therapeutic role of CRT, providing a comprehensive review of the available data coming from clinical studies and trials.

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“…It may offer the implanter the option of stability and good pacing capture without repositioning the lead at implant or during follow‐up. Finally, it is also conceivable that a better hemodynamic response may be achieved with multipolar leads . Coronary veins typically taper with smaller diameters in the distal or apical regions in comparison to larger diameters in more proximal or mid to basal regions.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, it is also conceivable that a better hemodynamic response may be achieved with multipolar leads. [11][12][13][14][15][16][17] Coronary veins typically taper with smaller diameters in the distal or apical regions in comparison to larger diameters in more proximal or mid to basal regions. Because of the diameter disparity, it is often more difficult to achieve myocardial contact and, therefore, acceptable pacing thresholds in mid-to-basal regions where the best hemodynamic response could be achieved.…”

Section: Introductionmentioning

confidence: 99%

Left Ventricular Three‐Dimensional Quadripolar Lead Acute Clinical Study: The LILAC Study

Philippon

Liu

Fung

et al. 2015

Pacing Clinical Electrophis

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Aims: This multicenter acute clinical study was designed to verify novel three-dimensional (3D)quadripolarResults: Eighty-seven leads were tested in 50 patients. When the best performing spiral electrode was chosen from each lead testing, the average of the best PCT on spiral in a wedged position was similar to the unwedged position (1.7 ± 1.5 V vs 1.9 ± 1.5 V, P = ns) and was similar to the wedged tip electrode average PCT (1.7 ± 1.5 V vs 1.6 ± 1. 6 V, P = ns). In the majority of patients (89-96%), pacing was achievable in a mid-basal ventricular location without PNS. Conclusions: This acute study demonstrated that a 3D quadripolar spiral lead design can achieve acceptable PCTs and avoid PNS without repositioning the lead at implant in the vast majority of patients.It also demonstrated that this lead design can achieve mid-basal ventricular stimulation with low PCT and good acute stability. (PACE 2015; 38:438-447) quadripolar leads, cardiac resynchronization, lead design

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Acute changes in electromechanical parameters during different pacing configurations using a quadripolar left ventricular lead

Abstract: In CRT patients receiving a quadripolar LV lead, significant variations in electromechanical parameters were observed by changing pacing vector. Individually targeting the optimal pacing site may enhance the acute haemodynamic response to CRT.

Cited by 10 publications

References 31 publications

A review of multisite pacing to achieve cardiac resynchronization therapy

A review of multisite pacing to achieve cardiac resynchronization therapy

The Role of Cardiac Resynchronization Therapy for the Management of Functional Mitral Regurgitation

Left Ventricular Three‐Dimensional Quadripolar Lead Acute Clinical Study: The LILAC Study

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