Comparison of the Effects of Epicardial and Endocardial Cardiac Resynchronization Therapy on Transmural Dispersion of Repolarization

Abstract

ms, P = 0.89) in both groups. Compared to transseptal endocardial CRT, epicardial CRT was associated with a significant increase in ± 18.9 ms, P = 0.01) and P = 0.04).Conclusion: Transseptal LV endocardial pacing is associated with significant reduction in TDR characteristics compared to epicardial pacing in CRT. Further studies are warranted to determine whether these effects may contribute to reduction of arrhythmias in patients with CRT. (PACE 2015; 0:1-7) cardiac resynchronization therapy, transmural dispersion of repolarization, transseptal endocardial biventricular pacing, heart failure, ventricular arrhythmias

Electro-echocardiographic Indices to Predict Cardiac Resynchronization Therapy Non-response on Non-ischemic Cardiomyopathy

“…Under physiological condition, hearts depolarize from endocardium to epicardium, and repolarize in an opposite direction35. However, CRT totally changes left ventriclular direction of depolarization and repolarization since its epicardial pacing, leading to TDR increasing36. It was reported that occurrence of tachycardia was higher in early stage of CRT implantation37.…”

The impact of the left ventricular pacing polarity and localization during cardiac resynchronization therapy on depolarization and repolarization parameters

“…Lead V5 or lead II (if lead V5 was unsuitable) was used for analysis. The QT interval was defined as the time from the beginning of the QRS complex to the end of the T wave ( 19 ). The QT interval was corrected and measured according to the Bazett’s formula ( 20 ).…”

“…Increased TDR measured by the T peak -T end (Tp-Te) and Tp-Te/QT ratio has been associated with a higher incidence of ventricular arrhythmias in patients who have received a CRT-D ( 18 ). CRT with trans-septal LV endocardial CRT increases the physiological activation and is associated with a significant reduction in the TDR characteristics compared with those in conventional epicardial pacing in CRT ( 19 ).…”

Sondenlose endokardiale linksventrikuläre Stimulation

“…Kleinere Studien haben einen Vorteil für die endokardiale linksventrikuläre Stimulation gezeigt [32][33][34]. So zeigt die endokardiale linksventrikuläre Stimulation signifikant geringere Erregungsdispersionen in Form schmalerer QRS-Breiten im Vergleich zu epikardialer linksventrikulärer Stimulation [35,36].…”