Acute haemodynamic comparison of multisite and biventricular pacing with a quadripolar left ventricular lead

Thibault, Bernard; Dubuc, Marc; Khairy, Paul; Guerra, Peter G.; Macle, Laurent; Rivard, Léna; Roy, Denis; Talajic, Mario; Karst, Edward; Ryu, Kyungmoo; Paiement, Patrice; Farazi, Taraneh G.

doi:10.1093/europace/eus435

Cited by 125 publications

(87 citation statements)

References 30 publications

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“…It has several advantages: adequated pacing thresholds, greater electrocatheter stability with low rates of electrode displacement, infrequent pacing of the phrenic nerve, pacing from basal left ventricle positions-apparently with better performance and ability to pacing around the scar tissue of the myocardiumand improved cardiac output in the medium to long term. Multipoint stimulation improves cardiac contractility to a greater extent than classical biventricular pacing [51], with an increase in the left ventricular ejection fraction of 12.7% compared to 6.7% in classic resynchronization [52].…”

Section: Optimization Of Resynchronization Therapymentioning

confidence: 94%

Cardiac Resynchronization Therapy in Advanced Heart Failure: Predictors of Response and Optimization of Therapy

Ángel¹,

Alfonso²,

Ángeles³

2017

The Role of the Clinical Cardiac Electrophysiologist in the Management of Congestive Heart Failure

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Heart failure affects a high percentage of the population, especially older patients. Cardiac resynchronization therapy is indicated in some patients with advanced heart failure. However, 20-40% of patients with implanted resynchronization device have no clinical response. In this chapter, we review factors related with the absence of a clinical response, recent technological advances that can reduce the failure rate, and an algorithm for management of patients without a clinical response.

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Section: Optimization Of Resynchronization Therapymentioning

confidence: 94%

Cardiac Resynchronization Therapy in Advanced Heart Failure: Predictors of Response and Optimization of Therapy

Ángel¹,

Alfonso²,

Ángeles³

2017

The Role of the Clinical Cardiac Electrophysiologist in the Management of Congestive Heart Failure

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“…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%

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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“…Some studies suggest an acute hemodynamic benefit associated with multisite pacing compared when with standard biventricular pacing. 54 Other clinical benefits include reduction in phrenic nerve stimulation and reduction in stimulation thresholds. Additional studies will be required to determine whether this lead technology facilitates identifying the site of maximal LV activation delay and improves clinical outcomes over the long term.…”

Section: Multipolar Leadsmentioning

confidence: 99%

Optimal Pacing for Right Ventricular and Biventricular Devices

Gillis

2014

Circ: Arrhythmia and Electrophysiology

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Acute haemodynamic comparison of multisite and biventricular pacing with a quadripolar left ventricular lead

Abstract: In the majority of patients, multisite pacing improved acute systolic function further compared with BiV pacing. Pacing with the most distal and proximal electrodes of the quadripolar LV lead most commonly yielded greatest LV dP/dtmax.

Cited by 125 publications

References 30 publications

Cardiac Resynchronization Therapy in Advanced Heart Failure: Predictors of Response and Optimization of Therapy

Cardiac Resynchronization Therapy in Advanced Heart Failure: Predictors of Response and Optimization of Therapy

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

Optimal Pacing for Right Ventricular and Biventricular Devices

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