Body surface mapping using an ECG belt to characterize electrical heterogeneity for different left ventricular pacing sites during cardiac resynchronization: Relationship with acute hemodynamic improvement

Long‐term electrical performance of Attain Performa quadripolar left ventricular leads with all steroid‐eluting electrodes: Results from a large worldwide clinical trial

“…The achievement of a stable and acceptable LV pacing threshold over time is necessary to enable the delivery of CRT at an individually targeted pacing site, with a possible trade‐off in energy drain from the battery. Additionally, noninvasive technologies, such as body surface mapping, may be used in conjunction with quadripolar leads for both selecting the optimal implant site and for programming optimization postimplant . Both targeted CRT delivery and battery drain (device longevity) are of key importance, being closely associated with patient outcome and long‐term replacement‐related complications, respectively.…”

Review on Smart Electro-Clothing Systems (SeCSs)

“…Dry electrodes show promise in the literature as durable sensor electrodes for long time monitoring; however, the signal quality deteriorates drastically when the wearer is in active mode such as walking or running, as dry electrodes cannot create a good adhesion on the skin like wet electrodes. Integrating dry electrodes at the strategic locations (where the body muscles do not move much during active modes) in compression garments enhances the signal quality [23]. Other than conductive Ag ink and Ag/AgCl ink, functional materials including carbon [24] conductive polymers such as PEDOT/PSS [Poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate)] [25] are used to measure signals like ECG.…”

The ECG Belt for CRT response trial: Design and clinical protocol

“…The electrocardiogram (ECG) Belt is a novel surface mapping system consisted of a two‐piece electrode array that wraps around the upper torso, with approximately 20 electrodes on each array, as well as four electrodes around the lower torso (Figure 1). 15 The system provides beat by beat isochronal maps of the anterior and posterior torso and quantifies electrical dyssynchrony, which may also be visualized, and helps measure the effect of LV lead location and different CRT parameters (e.g., pacing vectors, pacing configuration, AV, VV timings, etc.). Two metrics of electrical heterogeneity are provided, that is, standard deviation of the activation times (SDAT) and left ventricular activation time (LVAT).…”

“…Based on these two metrics, the ECG Belt system can rapidly provide relative electrical resynchronization measures in different pacing configurations, LV lead locations, and electrical delays. Pilot studies have shown a correlation between changes in SDAT and LVAT and changes in LV dp/dt and reverse ventricular remodeling 15,16 . The ECG Belt system does not require any imaging CT, magnetic resonance imaging (MRI), or echocardiography) and performs mapping from a lesser number (∼40) of electrodes on the body‐surface compared to ECGi.…”