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Single-Point Left Ventricular Pacing Optimized by ECG Results in Better Resynchronization than Multipoint Pacing

Single-Point Left Ventricular Pacing Optimized by ECG Results in Better Resynchronization than Multipoint Pacing

Authors :
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
Levio Quinto
Publication Year :
2020
Publisher :
Authorea, Inc., 2020.

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

Details

Database :
OpenAIRE
Accession number :
edsair.doi...........e691f3bd20a1ecd06a6272ff58ebb4b5
Full Text :
https://doi.org/10.22541/au.160193380.03603072/v1