P260Electrical latency (Q-LV) predicts the optimal LV endocardial pacing site; results from a multi-centre registry
Year: 2017
Type: conference-abstract
Abstract: Funding Acknowledgements: Dr Betts is supported by the Oxford Biomedical Research Centre Background: CRT delivered via biventricular endocardial (BIV ENDO) pacing may produce superior hemodynamic response compared to standard CRT. The optimal left ventricular endocardial (LV ENDO) stimulation may vary between patients and in patients with myocardial scar. Objective: We studied the optimal LV ENDO pacing site by evaluating the relationship between the Q-LV time and change in AHR at differing LV ENDO pacing locations during BIV ENDO pacing. Methods: Registry of LV endocardial acute pacing studies from five international centres: Johns Hopkins- USA, Bordeaux- France, Leiden- The Netherlands, Oxford- United Kingdom and King’s College London- United Kingdom. AHR was measured acutely with a pressure wire and optimal sites were defined using a modified 9 segment version of the AHA 17 segment circumferential polar plot. Results: Patients were predominantly male with a mean age of 66.4±11.3 years, the mean LVEF was 24.6%±7.7%. The mean QRS duration was 163±30ms and there was similar distribution of ischemic and non ischemic patients. 39 patients had AHR and QLV measurements incorporating 191 endocardial pacing locations. Q-LV times were significantly longer at the optimal hemodynamic location than in the least favourable location (127ms vs 89ms, p<0.01). For every increase of 50ms in QLV, the AHR improved by 6%, see Figure 1. This correlation was driven by the non-ischemic cohort (DCM) where a strong correlation between AHR and QLV was identified (p=0.002). The magnitude of change amongst the ischaemic cardiomyopathy (ICM) cohort was half that of the DCM patients (p=0.001). Conclusions: Electrical latency measured using QLV is correlated to AHR during endocardial pacing, across both ischaemic and non-ischaemic patients. The greater magnitude of change amongst DCM patients reflect the confounding effect of myocardial scar amongst the ICM cohort. Abstract P260 Figure.
Source: EP Europace
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2700875243