Pressure-Volume Loop Analysis of Multipoint Pacing With a Quadripolar Left Ventricular Lead in Cardiac Resynchronization Therapy

JACC. Clinical Electrophysiology
Wouter M van EverdingenMathias Meine

Abstract

This study aimed to compare multipoint pacing (MPP) to optimal biventricular pacing with a quadripolar left ventricular (LV) lead and find factors associated with hemodynamic response to MPP. MPP with a quadripolar LV lead may increase response to cardiac resynchronization therapy. Heart failure patients with a left bundle branch block underwent cardiac resynchronization therapy implantation. Q to LV sensing interval divided by the intrinsic QRS duration was measured. Invasive pressure-volume loops were assessed during 4 biventricular pacing settings and 3 MPP settings, using 4 atrioventricular delays. Hemodynamic response was defined as change in stroke work (Δ%SW) compared with baseline measurements during intrinsic conduction. Δ%SW of MPP was compared with conventional biventricular pacing using the distal electrode and the electrode with highest Δ%SW (BIV-OPT). Forty-three patients were analyzed (age 66 ± 10 years, 63% men, 30% ischemic cardiomyopathy, LV ejection fraction 29 ± 8%, and QRS duration 175 ± 13 ms). Q to local LV sensing interval corrected for QRS duration was 84 ± 8%, and variation between LV electrodes was 9 ± 5%. Compared with conventional biventricular pacing using the distal electrode, MPP showed a signifi...Continue Reading

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Citations

Nov 27, 2019·Current Cardiology Reports·Frederick G P Welt, James C Fang
Jul 29, 2019·Heart Failure Reviews·Huolan ZhuFang Wang
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Sep 9, 2021·Current Heart Failure Reports·Christian ButterMartin Stockburger
Jan 16, 2022·Heart Rhythm : the Official Journal of the Heart Rhythm Society·F Daniel RamirezPierre Jaïs

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Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Wouter M van EverdingenMathias Meine
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