Comparison of Echocardiographic and Electrocardiographic Mapping for Cardiac Resynchronisation Therapy Optimisation.
Comparison of Echocardiographic and Electrocardiographic Mapping for Cardiac Resynchronisation Therapy Optimisation. Cardiol Res Pract. 2019;2019:4351693 Authors: Pereira H, Jackson TA, Claridge S, Behar JM, Yao C, Sieniewicz B, Gould J, Porter B, Sidhu B, Gill J, Niederer S, Rinaldi CA Abstract Study hypothesis: We sought to investigate the association between echocardiographic optimisation and ventricular activation time in cardiac resynchronisation therapy (CRT) patients, obtained through the use of electrocardiographic mapping (ECM). We hypothesised that echocardiographic optimisation of the pacing delay between the atrial and ventricular leads-atrioventricular delay (AVD)-and the delay between ventricular leads-interventricular pacing interval (VVD)-would correlate with reductions in ventricular activation time. Background: Optimisation of AVD and VVD may improve CRT patient outcome. Optimal delays are currently set based on echocardiographic indices; however, acute studies have found that reductions in bulk ventricular activation time correlate with improvements in acute haemodynamic performance. Materials and methods: Twenty-one patients with established CRT criteria were recruited. After implantation, patients underwent echo-guided optimisation of the AVD and VVD. During this procedure, the participants also underwent noninvasive ECM. ECM maps were constructed for each AVD and VVD. ECM maps were analysed offline. Total ventricular activ...
ConclusionsThe declared outcome of the LBBB groups reflects inevitably the survival outcome of their non ‐ICM patients and not the intended outcome of patients with LBBB. CRT‐D in patients with different aetiologies of cardiomyopathy calls for separate evaluation.
Journal of Cardiovascular Electrophysiology, EarlyView.
AbstractPurposeEffectiveness of cardiac resynchronization therapy (CRT) in patients without left bundle branch block (non-LBBB) QRS morphology is limited. Additional selection criteria are needed to identify these patients.MethodsSeven hundred ninety consecutive patients with non-LBBB morphology, who received a CRT-device in 3 university centers in the Netherlands, were selected. Pre-implantation 12-lead ECGs were evaluated on morphology, duration, and area of the QRS complex, as well as on PR interval, left ventricular activation time (LVAT), and the presence of fragmented QRS (fQRS). Association of these ECG features wit...
ConclusionHBP is a viable technique for pursuing CRT in patients with LBBB ‐mediated cardiomyopathy.
ConclusionsIn patients with LBBB and CRT indication, the QS pattern in lead V1 predicts the correction of the QRS with HBP. In the case of rS pattern in lead V1, the ratio descending/ascending S wave component duration has a strong correlation with the LBBB correction.This article is protected by copyright. All rights reserved
ConclusionHis ‐bundle pacing is a viable technique for pursuing cardiac resynchronization therapy in patients with LBBB mediated cardiomyopathy.This article is protected by copyright. All rights reserved.
ConclusionElectrical mapping of CS allows identifying the latest activated branches. This finding may contribute to simplify CRT device implantation compared to activation mapping of all the branches.This article is protected by copyright. All rights reserved.
In conclusion, CRT improved non-uniformity of wall thickening between the LV septal and lateral regions evaluated using QGS, which is predictive of better prognosis in the chronic phase after CRT. PMID: 32493869 [PubMed - in process]
AbstractPurpose of ReviewCardiac resynchronization therapy (CRT) is an established modality for treating heart failure. However, one-third of patients do not respond and it is increasingly recognized that response is not binary and we should be aiming for “best response”. This review looks at factors predicting response and remodelling and highlights areas where we may improve both the proportion of responders but also maximize response in an individual.Recent FindingsWe review the clinical characteristics predicting response including structural and electrical remodelling and discuss areas of debate. We examin...
AbstractA prolonged QRS duration (QRSd) is promising for a response to cardiac resynchronization therapy (CRT). The variation in human body sizes may affect the QRSd. We hypothesized that conduction disturbances may exist in Japanese even with a narrow (