Guidance for Optimal Site Selection of a Leadless Left Ventricular Endocardial Electrode Improves Acute Hemodynamic Response and Chronic Remodeling

JACC. Clinical Electrophysiology
Benjamin J SieniewiczChristopher A Rinaldi

Abstract

This study hypothesized that guided implants, in which the optimal left ventricular endocardial (LVENDO) pacing location was identified and targeted, would improve acute markers of contractility and chronic markers of cardiac resynchronization (CRT) response. Biventricular endocardial (BiVENDO) pacing may offer a potential benefit over standard CRT; however, the optimal LVENDO pacing site is highly variable. Indiscriminately delivered BiVENDO pacing is associated with a reverse remodeling response rate of between 40% and 60%. Registry of centers implanting a wireless, LVENDO pacing system (WiSE-CRT System, EBR Systems, Sunnyvale, California); John Radcliffe Hospital (Oxford, United Kingdom), Guy's and St. Thomas' Hospital (London, United Kingdom), and The James Cook University Hospital (Middlesbrough, United Kingdom). Centers used a combination of preprocedural imaging and electroanatomical mapping the identify the optimal LVENDO site. A total of 26 patients across the 3 centers underwent a guided implant. Patients were predominantly male with a mean age of 68.8 ± 8.4 years, the mean LV ejection fraction was 34.2 ± 7.8%. The mean QRS duration was 163.8 ± 26.7 ms, and 30.8% of patients had an ischemic etiology. It proved technic...Continue Reading

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Citations

Jun 22, 2019·Pacing and Clinical Electrophysiology : PACE·Elisabetta MontemerloGiovanni Rovaris
Jul 22, 2020·Open Heart·Baldeep Singh SidhuGerald Carr-White
Apr 25, 2020·Pacing and Clinical Electrophysiology : PACE·Baldeep S SidhuChristopher A Rinaldi
Jul 25, 2019·Journal of Cardiovascular Translational Research·Hans Thijs van den BroekRené van Es
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Oct 28, 2019·Journal of the American Heart Association·Yanrong YinWei Li
Mar 20, 2019·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Vincent GalandChristophe Leclercq
May 4, 2021·Arrhythmia & Electrophysiology Review·Baldeep S SidhuChristopher A Rinaldi

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