Waddingham, PH;
Mangual, J;
Orini, M;
Badie, N;
McSpadden, L;
Lambiase, PD;
Chow, AWC;
(2021)
Noninvasive electrocardiographic imaging of dynamic atrioventricular delay programming in a patient with left bundle branch block.
HeartRhythm Case Reports
, 7
(12)
pp. 849-853.
10.1016/j.hrcr.2021.09.009.
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Abstract
Introduction The response to cardiac resynchronization therapy (CRT) is determined by various factors, including left ventricular (LV) lead location, atrioventricular (AV) delay, and inter-/intraventricular delays. Advances in quadripolar lead technology and device algorithms have improved patient response, yet selection of optimal settings remains challenging. Studies have shown acute improvement in electrical synchrony with manual AV optimization by fusion optimized intervals1,2; automated device algorithms, for example AdaptivCRT (Medtronic, Minneapolis, MN),3 SmartDelay (Boston Scientific, Marlborough, MA),4 and SyncAVTM (Abbott, Sylmar, CA)5; and pacing from multiple LV lead electrodes with MultiPoint Pacing (MPP).6,7 The aim of this clinical case report was to evaluate the acute benefits of SyncAV Plus in the new-generation, Bluetooth-enabled GallantTM CRT device (Abbott, Sylmar, CA). SyncAV Plus continually programs the paced AV delay shorter than the intrinsic PR interval by a programmable offset (% of PR duration) to synchronize intrinsic and ventricular paced activation wavefronts. Twelve-lead electrocardiogram (ECG) and noninvasive electrocardiographic imaging (ECGi) epicardial mapping analyses were performed to characterize the impact of SyncAV Plus on electrical synchrony during a range of CRT programming strategies, including biventricular (BiV) pacing, MPP, LV-only pacing, and LV-only pacing with MPP.
| Type: | Article |
|---|---|
| Title: | Noninvasive electrocardiographic imaging of dynamic atrioventricular delay programming in a patient with left bundle branch block |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.hrcr.2021.09.009 |
| Publisher version: | https://doi.org/10.1016/j.hrcr.2021.09.009 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | CRT optimization, SyncAV, Electrocardiography imaging, Atrioventricular delay, MultiPoint Pacing |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10140496 |
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