Cardiac resynchronization therapy when no lateral pacing option exists: vectorcardiographic guided non-lateral left ventricular lead placement predicts acute hemodynamic response

Ross, Stian; Odland, Hans Henrik; Aranda, Alfonso; Edvardsen, Thor; Gammelsrud, Lars Ove; Håland, Trine F.; Cornelussen, Richard; Hopp, Einar; Kongsgaard, Erik

doi:10.1093/europace/eux249

Cited by 4 publications

(2 citation statements)

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“…The magnitude of reduction in QRS duration with biventricular pacing has also been shown to be predictive of echocardiographic and clinical response to CRT 37-41 . In studies of optimizing interventricular intervals in biventricular pacing, minimization of QRS area has been associated with improved acute hemodynamic response to CRT 42-44 . The prognostic significance QRS area reduction has not been evaluated, however as QRS area is a function of QRS duration and amplitude, it is plausible that reduction in QRS area with CRT is also predictive of long‐term response.…”

Section: Discussionmentioning

confidence: 99%

“…[37][38][39][40][41] In studies of optimizing interventricular intervals in biventricular pacing, minimization of QRS area has been associated with improved acute hemodynamic response to CRT. [42][43][44] The prognostic significance QRS area reduction has not been evaluated, however as QRS area is a function of QRS duration and amplitude, it is plausible that reduction in QRS area with…”

Section: Follow Upmentioning

confidence: 99%

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Sequential His bundle and left ventricular pacing for cardiac resynchronization

Deshmukh

Sattur

Bechtol

et al. 2020

Cardiovasc electrophysiol

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Introduction Fusion of left ventricular pacing with intrinsic conduction provides superior resynchronization compared to biventricular pacing. His bundle pacing (HBP) preserves intrinsic conduction and allows for constant fusion with left ventricular pacing. This study evaluated sequential His bundle and left ventricular pacing for cardiac resynchronization therapy (CRT). Methods In patients referred for CRT, sequential His bundle and left ventricular pacing was performed when HBP did not correct the QRS. At implant, QRS duration and area were compared between biventricular pacing and His bundle and left ventricular pacing. Devices were programmed for His and left ventricular pacing. Functional status and echocardiography were evaluated in follow up. Results Twenty‐one patients, seven female, 70.7 ± 9.9 years, 57% with nonischemic cardiomyopathy were included. Baseline QRS duration was 170 ± 21 ms and was 157 ± 16 ms with HBP. Biventricular pacing resulted in a QRS duration of 141 ± 15 ms and decreased to 110 ± 14 ms with His bundle and left ventricular pacing (p < .0005). His bundle and left ventricular pacing resulted in a smaller paced QRS area (38.5 ± 22.6 µVs) compared to biventricular pacing (67.5 ± 24.0 µVs) and baseline (78.1 ± 28.1 µVs; p < .0005). Left ventricular ejection fraction increased from 27.6 ± 6.4% to 41.1 ± 12.5 (at 25 mean months, p = .001) and functional class improved from 3.1 ± 0.5 to 2.1 ± 0.8 (at mean 32 months, p < .001). Conclusions Sequential His bundle and left ventricular pacing results in superior electrical synchrony in patients with indication for CRT when HBP does not correct the QRS and resulted in promising clinical and echocardiographic response rates.

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Section: Discussionmentioning

confidence: 99%