The Use of Epicardial Electrogram as a Simple Guide to Select the Optimal Site of Left Ventricular Pacing in Cardiac Resynchronization Therapy

Cardiac resynchronization therapy (CRT) has been demonstrated to improve symptoms and survival in patients with left ventricular (LV) systolic dysfunction and dyssynchrony. To achieve this goal, the LV lead should be positioned in a region of delayed contraction. We hypothesized that pacing at the s...

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Bibliographic Details
Published in:Cardiology research and practice 2011-01, Vol.2011 (2011), p.1-8
Main Authors: Fatemi, Marjaneh, Le Gal, Grégoire, Blanc, Jean-Jacques, Mansourati, Jacques, Etienne, Yves
Format: Article
Language:English
Subjects:
Cardiac pacing
Cardiac patients
Care and treatment
Clinical Study
Diagnosis
Heart ventricle, Left
Human health and pathology
Life Sciences
Methods
Physiological aspects
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Summary:Cardiac resynchronization therapy (CRT) has been demonstrated to improve symptoms and survival in patients with left ventricular (LV) systolic dysfunction and dyssynchrony. To achieve this goal, the LV lead should be positioned in a region of delayed contraction. We hypothesized that pacing at the site of late electrical activation was also associated with long-term response to CRT. We conducted a retrospective study on 72 CRT patients. For each patient, we determined the electrical delay (ED) from the onset of QRS to the epicardial EGM and the ratio of ED to QRS duration (ED/QRS duration). After a followup of 30 ± 20 months, 47 patients responded to CRT. Responders had a significantly longer ED and greater ratio of ED/QRS duration than nonresponders. An ED/QRS duration ≥0.38 predicted a response to CRT with 89% specificity and 53% sensitivity.
ISSN:2090-8016
2090-0597
2090-0597
DOI:10.4061/2011/956062