Back to Search
Start Over
Electrical delays in quadripolar leads with cardiac resynchronization therapy
- Source :
- Journal of cardiovascular electrophysiologyREFERENCES. 32(9)
- Publication Year :
- 2021
-
Abstract
- BACKGROUND Pacing at sites of late intraventricular activation (QLV) or long interventricular conduction (right ventricle [RV]-left ventricular [LV]) have been associated with improved cardiac resynchronization therapy (CRT) outcomes. Quadripolar leads improve CRT outcomes by allowing for electrical repositioning to optimize pacing sites. However, little is known regarding the effect of such repositioning on electrical delay. OBJECTIVE Determine the relationship between different electrical bipoles from a quadripolar lead and measures of electrical delay. METHODS Forty-six patients underwent CRT with a quadripolar lead. The RV-LV and QLV intervals were measured for both the proximal and distal bipoles and the difference (Δ) between bipoles for each measure were calculated. Multivariate analyses were performed to identify predictors of electrical delays. RESULTS This was a typical CRT population with a mean age of 65 years and ejection fraction of 27%, with left bundle branch block (LBBB) present in 70%. The regression model for ΔQLV was significant (p = .05), with both gender (p = .008) and LBBB status (p = .020) significant predictors. The overall regression model for ΔRV-LV was not significant. ΔQLV and ΔRV-LV were significant among LBBB patients. Among non-LBBB, only ΔRV-LV was significant (mean: 7.2 ms, p = .006). ΔRV-LV versus ΔQLV were strongly correlated in LBBB (R2 = .92) but not non-LBBB (R2 = .06). CONCLUSION In LBBB, ΔRV-LV and ΔQLV are closely correlated suggesting that the proximal bipole and thus basal LV pacing sites should be selected when feasible. Greater variation in activation pattern is present in non-LBBB, so pacing sites should be individualized.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Heart Ventricles
Population
Bundle-Branch Block
Cardiac resynchronization therapy
Activation pattern
Cardiac Resynchronization Therapy
Basal (phylogenetics)
Electrocardiography
Physiology (medical)
Internal medicine
Left bundle branch
medicine
Humans
education
Lead (electronics)
Aged
Heart Failure
education.field_of_study
Ejection fraction
business.industry
medicine.anatomical_structure
Ventricle
Cardiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15408167
- Volume :
- 32
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Journal of cardiovascular electrophysiologyREFERENCES
- Accession number :
- edsair.doi.dedup.....ff60e186847b0cf95ad972cf59de9db5