Vectorcardiographic QRS area identifies delayed left ventricular lateral wall activation determined by electroanatomic mapping in candidates for cardiac resynchronization therapy

Biventricular Paced QRS Area Predicts Acute Hemodynamic CRT Response Better Than QRS Duration or QRS Amplitudes

“…6 Mafi et al showed a clear correlation between QRS area of the 3D vector loop and delayed left ventricular activation, when using a cutoff > 69 μVs. 5 The median 3D Area in our study was higher than those cutoffs, which may be linked to the high response rate in this study (86% of the configurations showed positive AHR).…”

“…Another intriguing question is whether reduction in paced QRS area (electrical changes after pacing) relates to resolving of dyssynchrony (functional changes after pacing). Although baseline QRS area identifies delayed left ventricular wall activation, causing dyssynchrony, it is currently unclear whether reduction in QRS area by BV pacing relates to the abolition of dyssynchrony . The value of BV paced QRS area to predict both long‐term clinical follow‐up and to resolve dyssynchrony should be determined in a larger, more heterogeneous population.…”

“…In current clinical practice, electrocardiographic (ECG) parameters, such as QRS duration (QRSD) and QRS morphology, are the most widely accepted methods to select patients for CRT . Recently, the area of the QRS complex (QRS area) obtained by vectorcardiography (VCG) has been proposed as a new parameter to select patients eligible for CRT . The QRS area of the intrinsic LBBB, which combines both QRSD and QRS morphology, has shown to predict CRT response and regions of delayed left ventricular activation better than QRSD or current LBBB definitions.…”

“…[2][3][4] Recently, the area of the QRS complex (QRS area) obtained by vectorcardiography (VCG) has been proposed as a new parameter to select patients eligible for CRT. 5,6 The QRS area of the intrinsic LBBB, which combines both QRSD and QRS morphology, has shown to predict CRT response and regions of delayed left ventricular activation better than QRSD or current LBBB definitions. We hypothesized that changes in VCG parameters, such as QRS area, occurring with BV pacing, might function as a noninvasive tool to predict acute CRT response.…”

Relation between electrical and mechanical dyssynchrony in patients with left bundle branch block: An electro‐ and vectorcardiographic study

“…This heterogeneity in mechanical dyssynchrony among patients with LBBB, is thought to be one of the reasons why a significant number of patients fail to respond to CRT (Auricchio et al., ). Several new electro‐ and vectorcardiographic parameters have been proposed as markers of both electrical and mechanical dyssynchrony (Del‐Carpio Munoz et al., ; van Deursen et al., ; Mafi Rad et al., ; Sweeney et al., ). However, these parameters were validated against different dyssynchrony assessments and not compared head to head.…”