Helder Pereira1, Tom A Jackson2, Benjamin Sieniewicz2, Justin Gould2, Cheng Yao3, Steven Niederer4, Christopher A Rinaldi2. 1. Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom. Electronic address: helder.pereira@kcl.ac.uk. 2. Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom; Cardiovascular Department, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. 3. Medtronic Ltd, United Kingdom. 4. Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
Abstract
BACKGROUND: Cardiac resynchronization therapy (CRT) is now generally delivered via quadripolar leads. Assessment of the effect of different vector programs from quadripolar leads on ventricular activation can be now done using non-invasive electrocardiographic mapping (ECM). MATERIAL AND METHODS: In nineteen patients with quadripolar LV leads, activation maps were constructed. The total ventricular activation time (TVaT) and the time for the bulk of ventricular activation (VaT10-90) were calculated. RESULTS: CRT delivered via a quadripolar lead significantly reduced TVaT and VaT10-90 by a mean of 16 ms and 31 ms, respectively, compared to baseline. There was a marked reduction in ventricular activation between the most and least synchronous vectors: 28% difference in baseline TVaT and 37% difference in VaT10-90. CONCLUSION: Changes in the configuration of an LV quadripolar lead significantly affected ventricular activation timings in both ischaemic and non-ischaemic subjects. This suggests that programming of the optimal pacing vector may need to be individually tailored. Crown
BACKGROUND: Cardiac resynchronization therapy (CRT) is now generally delivered via quadripolar leads. Assessment of the effect of different vector programs from quadripolar leads on ventricular activation can be now done using non-invasive electrocardiographic mapping (ECM). MATERIAL AND METHODS: In nineteen patients with quadripolar LV leads, activation maps were constructed. The total ventricular activation time (TVaT) and the time for the bulk of ventricular activation (VaT10-90) were calculated. RESULTS: CRT delivered via a quadripolar lead significantly reduced TVaT and VaT10-90 by a mean of 16 ms and 31 ms, respectively, compared to baseline. There was a marked reduction in ventricular activation between the most and least synchronous vectors: 28% difference in baseline TVaT and 37% difference in VaT10-90. CONCLUSION: Changes in the configuration of an LV quadripolar lead significantly affected ventricular activation timings in both ischaemic and non-ischaemic subjects. This suggests that programming of the optimal pacing vector may need to be individually tailored. Crown
Authors: Helder Pereira; Tom A Jackson; Simon Claridge; Jonathan M Behar; Cheng Yao; Benjamin Sieniewicz; Justin Gould; Bradley Porter; Baldeep Sidhu; Jaswinder Gill; Steven Niederer; Christopher A Rinaldi Journal: Cardiol Res Pract Date: 2019-02-21 Impact factor: 1.866
Authors: Thomas Jackson; Simon Claridge; Jonathan Behar; Cheng Yao; Mark Elliott; Vishal Mehta; Justin Gould; Baldeep Sidhu; Helder Pereira; Steven Niederer; Gerald Carr-White; Christopher A Rinaldi Journal: Heart Rhythm O2 Date: 2021-01-12