1. Single-Point Left Ventricular Pacing Optimized by ECG Results in Better Resynchronization than Multipoint Pacing
- Author
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Maria S. Guillem, Felipe Atienza, Francisco Alarcón, Rodolfo San Antonio, Marta Sitges, Alejandro Liberos, Luis Mont Girbau, Eduard Guasch, Omar Trotta, Ana Gonzalez-Ascaso, Roger Borràs, Rafael Jiménez-Arjona, Paz Garre, Andreu M. Climent, Margarida Pujol-López, Adelina Doltra, Ivo Roca-Luque, José María Tolosana, Josep Brugada, Elena Arbelo, Francisco Fernández-Avilés, and Levio Quinto
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Cardiac resynchronization therapy ,Ventricular pacing ,QRS complex ,medicine.anatomical_structure ,Ventricle ,Internal medicine ,Electrocardiographic imaging ,medicine ,Cardiology ,cardiovascular diseases ,Single point ,Reverse remodeling ,business - Abstract
Background: Multipoint pacing (MPP) in cardiac resynchronization therapy (CRT) activates the left ventricle from two locations, thereby shortening the QRS duration and enabling better resynchronization; however, compared with conventional CRT, MPP reduces battery longevity. On the other hand, electrocardiogram-based optimization using the fusion-optimized intervals (FOI) method achieves more significant reverse remodeling than nominal CRT programming. Our study aimed to determine whether MPP could attain better resynchronization than single-point pacing (SPP) optimized by FOI. Methods: This prospective study included 32 consecutive patients who successfully received CRT devices with MPP capabilities. After implantation, the QRS duration was measured during intrinsic rhythm and with three pacing configurations: MPP, SPP-FOI, and MPP-FOI. In 14 patients, biventricular activation times (by electrocardiographic imaging, ECGI) were obtained during intrinsic rhythm and for each pacing configuration to validate the findings. Device battery longevity was estimated at the 45-day follow-up. Results: The SPP-FOI method achieved greater QRS shortening than MPP (-56±16 vs. -42±17 ms, P
- Published
- 2020