Non-invasive electrophysiological assessment of the optimal configuration of quadripolar lead vectors on ventricular activation times

Helder Pereira; Tom A. Jackson; Benjamin Sieniewicz; Justin Gould; Cheng Yao; Steven Niederer; Christopher A. Rinaldi

doi:10.1016/j.jelectrocard.2018.05.006

Non-invasive electrophysiological assessment of the optimal configuration of quadripolar lead vectors on ventricular activation times

Helder Pereira^*, Tom A. Jackson, Benjamin Sieniewicz, Justin Gould, Cheng Yao, Steven Niederer, Christopher A. Rinaldi

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
Cardiac resynchronization therapy (CRT) is now generally delivered via quadripolar leads. Assessment of the effect of different vector programs from quadripolar leads on ventricular activation can be now done using non-invasive electrocardiographic mapping (ECM).

Material and methods
In nineteen patients with quadripolar LV leads, activation maps were constructed. The total ventricular activation time (TVaT) and the time for the bulk of ventricular activation (VaT10–90) were calculated.

Results
CRT delivered via a quadripolar lead significantly reduced TVaT and VaT10–90 by a mean of 16 ms and 31 ms, respectively, compared to baseline. There was a marked reduction in ventricular activation between the most and least synchronous vectors: 28% difference in baseline TVaT and 37% difference in VaT10–90.

Conclusion
Changes in the configuration of an LV quadripolar lead significantly affected ventricular activation timings in both ischaemic and non-ischaemic subjects. This suggests that programming of the optimal pacing vector may need to be individually tailored.

Original language	English
Pages (from-to)	714-719
Number of pages	6
Journal	Journal of Electrocardiology
Volume	51
Issue number	4
Early online date	16 May 2018
DOIs	https://doi.org/10.1016/j.jelectrocard.2018.05.006
Publication status	Published - 1 Jul 2018

Keywords

Cardiac resynchronization therapy
Non-invasive electrocardiographic mapping
Quadripolar left ventricular lead
Optimisation
Ventricular activation time

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10.1016/j.jelectrocard.2018.05.006

Non-invasive electrophysiological assessment of_PEREIRA_Publishedonline16May2018_GREEN AAM (CC BY-NC-ND)
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Cite this

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title = "Non-invasive electrophysiological assessment of the optimal configuration of quadripolar lead vectors on ventricular activation times",

abstract = "Background Cardiac resynchronization therapy (CRT) is now generally delivered via quadripolar leads. Assessment of the effect of different vector programs from quadripolar leads on ventricular activation can be now done using non-invasive electrocardiographic mapping (ECM). Material and methods In nineteen patients with quadripolar LV leads, activation maps were constructed. The total ventricular activation time (TVaT) and the time for the bulk of ventricular activation (VaT10–90) were calculated. Results CRT delivered via a quadripolar lead significantly reduced TVaT and VaT10–90 by a mean of 16 ms and 31 ms, respectively, compared to baseline. There was a marked reduction in ventricular activation between the most and least synchronous vectors: 28% difference in baseline TVaT and 37% difference in VaT10–90. Conclusion Changes in the configuration of an LV quadripolar lead significantly affected ventricular activation timings in both ischaemic and non-ischaemic subjects. This suggests that programming of the optimal pacing vector may need to be individually tailored.",

keywords = "Cardiac resynchronization therapy, Non-invasive electrocardiographic mapping, Quadripolar left ventricular lead, Optimisation, Ventricular activation time",

author = "Helder Pereira and Jackson, {Tom A.} and Benjamin Sieniewicz and Justin Gould and Cheng Yao and Steven Niederer and Rinaldi, {Christopher A.}",

year = "2018",

month = jul,

day = "1",

doi = "10.1016/j.jelectrocard.2018.05.006",

language = "English",

volume = "51",

pages = "714--719",

journal = "Journal of Electrocardiology",

issn = "0022-0736",

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T1 - Non-invasive electrophysiological assessment of the optimal configuration of quadripolar lead vectors on ventricular activation times

AU - Pereira, Helder

AU - Jackson, Tom A.

AU - Sieniewicz, Benjamin

AU - Gould, Justin

AU - Yao, Cheng

AU - Niederer, Steven

AU - Rinaldi, Christopher A.

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background Cardiac resynchronization therapy (CRT) is now generally delivered via quadripolar leads. Assessment of the effect of different vector programs from quadripolar leads on ventricular activation can be now done using non-invasive electrocardiographic mapping (ECM). Material and methods In nineteen patients with quadripolar LV leads, activation maps were constructed. The total ventricular activation time (TVaT) and the time for the bulk of ventricular activation (VaT10–90) were calculated. Results CRT delivered via a quadripolar lead significantly reduced TVaT and VaT10–90 by a mean of 16 ms and 31 ms, respectively, compared to baseline. There was a marked reduction in ventricular activation between the most and least synchronous vectors: 28% difference in baseline TVaT and 37% difference in VaT10–90. Conclusion Changes in the configuration of an LV quadripolar lead significantly affected ventricular activation timings in both ischaemic and non-ischaemic subjects. This suggests that programming of the optimal pacing vector may need to be individually tailored.

AB - Background Cardiac resynchronization therapy (CRT) is now generally delivered via quadripolar leads. Assessment of the effect of different vector programs from quadripolar leads on ventricular activation can be now done using non-invasive electrocardiographic mapping (ECM). Material and methods In nineteen patients with quadripolar LV leads, activation maps were constructed. The total ventricular activation time (TVaT) and the time for the bulk of ventricular activation (VaT10–90) were calculated. Results CRT delivered via a quadripolar lead significantly reduced TVaT and VaT10–90 by a mean of 16 ms and 31 ms, respectively, compared to baseline. There was a marked reduction in ventricular activation between the most and least synchronous vectors: 28% difference in baseline TVaT and 37% difference in VaT10–90. Conclusion Changes in the configuration of an LV quadripolar lead significantly affected ventricular activation timings in both ischaemic and non-ischaemic subjects. This suggests that programming of the optimal pacing vector may need to be individually tailored.

KW - Cardiac resynchronization therapy

KW - Non-invasive electrocardiographic mapping

KW - Quadripolar left ventricular lead

KW - Optimisation

KW - Ventricular activation time

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DO - 10.1016/j.jelectrocard.2018.05.006

M3 - Article

SN - 0022-0736

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EP - 719

JO - Journal of Electrocardiology

JF - Journal of Electrocardiology

IS - 4

ER -

Non-invasive electrophysiological assessment of the optimal configuration of quadripolar lead vectors on ventricular activation times

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