Acute effects of multisite left ventricular pacing on mechanical dyssynchrony in patients receiving cardiac resynchronization therapy

C. Aldo Rinaldi, Wolfgang Kranig, Christophe Leclercq, Salem Kacet, Tim Betts, Pierre Bordachar, Klaus Jürgen Gutleben, Anoop Shetty, Allen Keel, Kyungmoo Ryu, Taraneh G. Farazi, Marcus Simon, Tasneem Z. Naqvi

Research output: Contribution to journalArticlepeer-review

Abstract

[Background: A novel quadripolar left ventricular (LV) pacing lead has the ability to deliver multisite LV pacing (MSLV). We set out to characterize the safety and changes in acute mechanical dyssynchrony with MSLV in cardiac resynchronization therapy (CRT) patients. Methods and Results: Prospective multicenter study in 52 patients receiving CRT. An acute pacing protocol comprising 8 MSLV configurations covering a range of delays was compared with conventional CRT (baseline). Transthoracic tissue Doppler imaging (TDI) was used to measure the standard deviation of time to peak contraction of 12 LV segments (Ts-SD) and delayed longitudinal contraction. No ventricular arrhythmia occurred in any of the 52 patients. Complete TDI datasets were collected in 41 patients. Compared with baseline: 1) The mean Ts-SD was significantly lower for the optimal MSLV configuration (35.3 ± 16.4 vs50.2 ± 19.1 ms; P < .(X)l);2)atleast 1 MSLV configuration exhibited a significant dyssynchrony improvement in 63% of patients; and 3) the mean number of LV segments with delayed longitudinal contractions was significantly reduced with the optimal MSLV configuration (0.37 ± 0.99 vs 2.20 ± 2.19; P < .001). Conclusions: Acute MSLV was acutely safe, and a proportion of MSLV vectors resulted in a significant reduction in echocardiographic dyssynchrony compared with conventional CRT.

Original languageEnglish (US)
Pages (from-to)376.e1-376.e8
JournalJournal of Cardiac Failure
Volume20
Issue number5
StatePublished - May 2014

Keywords

  • Cardiac resynchronization therapy
  • biventricular pacing
  • dyssynchrony
  • heart failure
  • left ventricular pacing leads
  • multisite pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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