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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 ± 36.4 vs 50.2 ± 29.1 ms; P < .001); 2) at least 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 ± 7.99 vs 2.20 ± 0.19; 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 publication

DOI

10.1016/j.cardfail.2013.10.003

Type

Journal article

Journal

J Card Fail

Publication Date

11/2013

Volume

19

Pages

731 - 738

Keywords

Cardiac resynchronization therapy, biventricular pacing, dyssynchrony, heart failure, left ventricular pacing leads, multisite pacing, Aged, Cardiac Resynchronization Therapy, Female, Humans, Male, Middle Aged, Myocardial Ischemia, Prospective Studies, Time Factors, Treatment Outcome, Ventricular Dysfunction, Left, Ventricular Function, Left