Improvement in acute contractility and hemodynamics with multipoint pacing via a left ventricular quadripolar pacing lead

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

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Introduction: A quadripolar left ventricular (LV) pacing can deliver multipoint pacing (MPP). It is unknown if this confers improved cardiac function compared to conventional cardiac resynchronization therapy (CRT). Methods and results: We aimed to characterize changes in acute cardiac contractility and hemodynamics with multisite left ventricular "multipoint" pacing (MPP) in a prospective multicenter study in patients implanted with a CRT-defibrillator incorporating a quadripolar LV lead. The device was programmed to deliver MPP acutely pacing with eight configurations of varying timing delays. Global peak LV radial strain and LV outflow velocity time integral (LVOT VTI) were measured for conventional CRT and each MPP configuration. Out of the eight tested MPP configurations, the one that yielded the best echocardiographic measurement for each patient was defined as "optimal MPP". Forty CRT recipients had complete radial strain datasets suitable for analysis. Compared to conventional CRT, the mean peak radial strain was significantly higher for the optimal MPP configuration (18.3 ± 7.4 vs. 9.3 ± 5.3 %, p < 0.001), and at least one MPP configuration was significantly superior (>20 %) in 63 % of patients. LVOT VTI data were collected in a subset of 13 patients. In these patients, mean VTI was significantly higher for optimal MPP compared to conventional CRT (13.5 ± 2.7 vs. 10.9 ± 3.3 cm, p < 0.01). Conclusion: MPP delivered via a quadripolar LV lead resulted in a significant improvement in acute cardiac contractility and hemodynamics compared to conventional CRT in the majority of patients studied. Clinical trial registration: Clinicaltrials.gov identifier NCT01044784.

Original languageEnglish (US)
Pages (from-to)75-80
Number of pages6
JournalJournal of Interventional Cardiac Electrophysiology
Volume40
Issue number1
DOIs
StatePublished - 2014
Externally publishedYes

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Cardiac Resynchronization Therapy
Hemodynamics
Defibrillators
Multicenter Studies
Clinical Trials
Prospective Studies
Equipment and Supplies

Keywords

  • Biventricular pacing
  • Cardiac function
  • Cardiac resynchronization therapy
  • Heart failure
  • Left ventricular pacing leads
  • Multisite pacing
  • Strain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Improvement in acute contractility and hemodynamics with multipoint pacing via a left ventricular quadripolar pacing lead. / Rinaldi, C. Aldo; Leclercq, Christophe; Kranig, Wolfgang; Kacet, Salem; Betts, Tim; Bordachar, Pierre; Gutleben, Klaus Jürgen; Shetty, Anoop; Donal, Erwan; Keel, Allen; Ryu, Kyungmoo; Farazi, Taraneh G.; Simon, Marcus; Naqvi, Tasneem Zehra.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 40, No. 1, 2014, p. 75-80.

Research output: Contribution to journalArticle

Rinaldi, CA, Leclercq, C, Kranig, W, Kacet, S, Betts, T, Bordachar, P, Gutleben, KJ, Shetty, A, Donal, E, Keel, A, Ryu, K, Farazi, TG, Simon, M & Naqvi, TZ 2014, 'Improvement in acute contractility and hemodynamics with multipoint pacing via a left ventricular quadripolar pacing lead', Journal of Interventional Cardiac Electrophysiology, vol. 40, no. 1, pp. 75-80. https://doi.org/10.1007/s10840-014-9891-1
Rinaldi, C. Aldo ; Leclercq, Christophe ; Kranig, Wolfgang ; Kacet, Salem ; Betts, Tim ; Bordachar, Pierre ; Gutleben, Klaus Jürgen ; Shetty, Anoop ; Donal, Erwan ; Keel, Allen ; Ryu, Kyungmoo ; Farazi, Taraneh G. ; Simon, Marcus ; Naqvi, Tasneem Zehra. / Improvement in acute contractility and hemodynamics with multipoint pacing via a left ventricular quadripolar pacing lead. In: Journal of Interventional Cardiac Electrophysiology. 2014 ; Vol. 40, No. 1. pp. 75-80.
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abstract = "Introduction: A quadripolar left ventricular (LV) pacing can deliver multipoint pacing (MPP). It is unknown if this confers improved cardiac function compared to conventional cardiac resynchronization therapy (CRT). Methods and results: We aimed to characterize changes in acute cardiac contractility and hemodynamics with multisite left ventricular {"}multipoint{"} pacing (MPP) in a prospective multicenter study in patients implanted with a CRT-defibrillator incorporating a quadripolar LV lead. The device was programmed to deliver MPP acutely pacing with eight configurations of varying timing delays. Global peak LV radial strain and LV outflow velocity time integral (LVOT VTI) were measured for conventional CRT and each MPP configuration. Out of the eight tested MPP configurations, the one that yielded the best echocardiographic measurement for each patient was defined as {"}optimal MPP{"}. Forty CRT recipients had complete radial strain datasets suitable for analysis. Compared to conventional CRT, the mean peak radial strain was significantly higher for the optimal MPP configuration (18.3 ± 7.4 vs. 9.3 ± 5.3 {\%}, p < 0.001), and at least one MPP configuration was significantly superior (>20 {\%}) in 63 {\%} of patients. LVOT VTI data were collected in a subset of 13 patients. In these patients, mean VTI was significantly higher for optimal MPP compared to conventional CRT (13.5 ± 2.7 vs. 10.9 ± 3.3 cm, p < 0.01). Conclusion: MPP delivered via a quadripolar LV lead resulted in a significant improvement in acute cardiac contractility and hemodynamics compared to conventional CRT in the majority of patients studied. Clinical trial registration: Clinicaltrials.gov identifier NCT01044784.",
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T1 - Improvement in acute contractility and hemodynamics with multipoint pacing via a left ventricular quadripolar pacing lead

AU - Rinaldi, C. Aldo

AU - Leclercq, Christophe

AU - Kranig, Wolfgang

AU - Kacet, Salem

AU - Betts, Tim

AU - Bordachar, Pierre

AU - Gutleben, Klaus Jürgen

AU - Shetty, Anoop

AU - Donal, Erwan

AU - Keel, Allen

AU - Ryu, Kyungmoo

AU - Farazi, Taraneh G.

AU - Simon, Marcus

AU - Naqvi, Tasneem Zehra

PY - 2014

Y1 - 2014

N2 - Introduction: A quadripolar left ventricular (LV) pacing can deliver multipoint pacing (MPP). It is unknown if this confers improved cardiac function compared to conventional cardiac resynchronization therapy (CRT). Methods and results: We aimed to characterize changes in acute cardiac contractility and hemodynamics with multisite left ventricular "multipoint" pacing (MPP) in a prospective multicenter study in patients implanted with a CRT-defibrillator incorporating a quadripolar LV lead. The device was programmed to deliver MPP acutely pacing with eight configurations of varying timing delays. Global peak LV radial strain and LV outflow velocity time integral (LVOT VTI) were measured for conventional CRT and each MPP configuration. Out of the eight tested MPP configurations, the one that yielded the best echocardiographic measurement for each patient was defined as "optimal MPP". Forty CRT recipients had complete radial strain datasets suitable for analysis. Compared to conventional CRT, the mean peak radial strain was significantly higher for the optimal MPP configuration (18.3 ± 7.4 vs. 9.3 ± 5.3 %, p < 0.001), and at least one MPP configuration was significantly superior (>20 %) in 63 % of patients. LVOT VTI data were collected in a subset of 13 patients. In these patients, mean VTI was significantly higher for optimal MPP compared to conventional CRT (13.5 ± 2.7 vs. 10.9 ± 3.3 cm, p < 0.01). Conclusion: MPP delivered via a quadripolar LV lead resulted in a significant improvement in acute cardiac contractility and hemodynamics compared to conventional CRT in the majority of patients studied. Clinical trial registration: Clinicaltrials.gov identifier NCT01044784.

AB - Introduction: A quadripolar left ventricular (LV) pacing can deliver multipoint pacing (MPP). It is unknown if this confers improved cardiac function compared to conventional cardiac resynchronization therapy (CRT). Methods and results: We aimed to characterize changes in acute cardiac contractility and hemodynamics with multisite left ventricular "multipoint" pacing (MPP) in a prospective multicenter study in patients implanted with a CRT-defibrillator incorporating a quadripolar LV lead. The device was programmed to deliver MPP acutely pacing with eight configurations of varying timing delays. Global peak LV radial strain and LV outflow velocity time integral (LVOT VTI) were measured for conventional CRT and each MPP configuration. Out of the eight tested MPP configurations, the one that yielded the best echocardiographic measurement for each patient was defined as "optimal MPP". Forty CRT recipients had complete radial strain datasets suitable for analysis. Compared to conventional CRT, the mean peak radial strain was significantly higher for the optimal MPP configuration (18.3 ± 7.4 vs. 9.3 ± 5.3 %, p < 0.001), and at least one MPP configuration was significantly superior (>20 %) in 63 % of patients. LVOT VTI data were collected in a subset of 13 patients. In these patients, mean VTI was significantly higher for optimal MPP compared to conventional CRT (13.5 ± 2.7 vs. 10.9 ± 3.3 cm, p < 0.01). Conclusion: MPP delivered via a quadripolar LV lead resulted in a significant improvement in acute cardiac contractility and hemodynamics compared to conventional CRT in the majority of patients studied. Clinical trial registration: Clinicaltrials.gov identifier NCT01044784.

KW - Biventricular pacing

KW - Cardiac function

KW - Cardiac resynchronization therapy

KW - Heart failure

KW - Left ventricular pacing leads

KW - Multisite pacing

KW - Strain

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