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Biventricular endocardial pacing and left bundle branch area pacing for cardiac resynchronization: Mechanistic insights from electrocardiographic imaging, acute hemodynamic response, and magnetic resonance imaging by Mark K. Elliott; Marina Strocchi; Benjamin J. Sieniewicz; Baldeep Sidhu; Vishal Mehta; Nadeev Wijesuriya; Jonathan M. Behar; Andrew Thorpe; Dejana Martic; Tom Wong; Steven Niederer; Christopher A. Rinaldi is a Medicine article available to read on EtoBox.

What is Biventricular endocardial pacing and left bundle branch area pacing for cardiac resynchronization: Mechanistic insights from electrocardiographic imaging, acute hemodynamic response, and magnetic resonance imaging about?

Background Biventricular endocardial pacing (BiV-endo) has demonstrated superior cardiac resynchronization compared to conventional biventricular epicardial pacing (BiV-epi). Left bundle branch area pacing (LBBAP) may also achieve effective cardiac resynchronization therapy (CRT). Objective The purpose of this study was to compare the acute electrical and hemodynamic effects of BiV-epi, BiV-endo, and LBBAP delivered from the LV endocardium and to assess how myocardial scar affects response. Methods Eleven patients with heart failure and indications for CRT underwent a temporary pacing study with electrocardiographic imaging (ECGi) and hemodynamic assessment. BiV-endo was delivered by stimulation of the left ventricular (LV) lateral wall, and LBBAP was delivered by stimulation of the LV septum, at the site of a Purkinje potential. LV activation time (LVAT-95), LV dyssynchrony index (LVDI), biventricular activation time (BIVAT-90), and biventricular dyssynchrony index (BIVDI) were calculated. Myocardial scar was assessed using magnetic resonance imaging (MRI). Results The protocol was completed in 10 patients. Compared to BiV-epi (LVAT-95: 79.2 ± 13.1 ms; LVDI: 26.6 ± 3.4 ms) LV resy

Who reads Biventricular endocardial pacing and left bundle branch area pacing for cardiac resynchronization: Mechanistic insights from electrocardiographic imaging, acute hemodynamic response, and magnetic resonance imaging?

Author

Mark K. Elliott; Marina Strocchi; Benjamin J. Sieniewicz; Baldeep Sidhu; Vishal Mehta; Nadeev Wijesuriya; Jonathan M. Behar; Andrew Thorpe; Dejana Martic; Tom Wong; Steven Niederer; Christopher A. Rinaldi

Publisher

Elsevier BV

Published

2023

Language

EN

Field

Medicine (Health Sciences)