Noninvasive Electrical Mapping Compared with the Paced QRS Complex for Optimizing CRT Programmed Settings and Predicting Multidimensional Response.

Autor: Morales FL; University of Virginia Health System, Charlottesville, VA, 22901, USA., Bivona DJ; University of Virginia Health System, Charlottesville, VA, 22901, USA., Abdi M; University of Virginia Health System, Charlottesville, VA, 22901, USA., Malhotra R; University of Virginia Health System, Charlottesville, VA, 22901, USA., Monfredi O; University of Virginia Health System, Charlottesville, VA, 22901, USA., Darby A; University of Virginia Health System, Charlottesville, VA, 22901, USA., Mason PK; University of Virginia Health System, Charlottesville, VA, 22901, USA., Mangrum JM; University of Virginia Health System, Charlottesville, VA, 22901, USA., Mazimba S; University of Virginia Health System, Charlottesville, VA, 22901, USA., Stadler RW; Medtronic plc., Mounds View, MN, USA., Epstein FH; University of Virginia Health System, Charlottesville, VA, 22901, USA., Bilchick KC; University of Virginia Health System, Charlottesville, VA, 22901, USA. kcb7f@uvahealth.org., Oomen PJA; Department of Biomedical Engineeering, Edwards Lifesciences Foundation Cardiovascular Innovation and Research Center, University of California, Irvine, Irvine, CA, USA.
Jazyk: angličtina
Zdroj: Journal of cardiovascular translational research [J Cardiovasc Transl Res] 2023 Dec; Vol. 16 (6), pp. 1448-1460. Date of Electronic Publication: 2023 Sep 06.
DOI: 10.1007/s12265-023-10418-1
Abstrakt: The aim was to test the hypothesis that left ventricular (LV) and right ventricular (RV) activation from body surface electrical mapping (CardioInsight 252-electrode vest, Medtronic) identifies optimal cardiac resynchronization therapy (CRT) pacing strategies and outcomes in 30 patients. The LV80, RV80, and BIV80 were defined as the times to 80% LV, RV, or biventricular electrical activation. Smaller differences in the LV80 and RV80 (|LV80-RV80|) with synchronized LV pacing predicted better LV function post-CRT (p = 0.0004) than the LV-paced QRS duration (p = 0.32). Likewise, a lower RV80 was associated with a better pre-CRT RV ejection fraction by CMR (r =  - 0.40, p = 0.04) and predicted post-CRT improvements in myocardial oxygen uptake (p = 0.01) better than the biventricular-paced QRS (p = 0.38), while a lower LV80 with BIV pacing predicted lower post-CRT B-type natriuretic peptide (BNP) (p = 0.02). RV pacing improved LV function with smaller |LV80-RV80| (p = 0.009). In conclusion, 3-D electrical mapping predicted favorable post-CRT outcomes and informed effective pacing strategies.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz: