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Ventricular activation patterns during different pacing modes. An insight from electroanatomical mapping.
Petr Peichl1, Josef Kautzner, Robert Cihak
1Department of Cardiology, Institute for Clinical and Experimental Medicine, Vídenská 1958/9, 14021 Praha 4, Czech Republic. petr.peichl@medicon.cz
Kardiologia Polska
|December 29, 2005
Summary
Biventricular pacing (BiV) and single-site left ventricular (LV) pacing with fusion most effectively alter ventricular activation patterns for cardiac resynchronization. These pacing modes show promise in improving heart failure management by optimizing electrical synchrony.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Biventricular pacing (BiV) is the standard for cardiac resynchronisation therapy.
- Limited data exists on how different pacing sites affect electrical activation sequences.
Purpose of the Study:
- To investigate changes in ventricular activation patterns across various pacing modes in patients with chronic heart failure.
- To compare the efficacy of different pacing strategies in altering electrical synchrony.
Main Methods:
- 20 patients with chronic heart failure and conduction abnormalities underwent endocardial mapping.
- Activation patterns, LV endocardial activation time (LVAT), and interventricular delay (IVD) were assessed during spontaneous rhythm and BiV, right ventricular bifocal (BiF), and single-site LV pacing.
Main Results:
- BiV pacing and BiF pacing shortened LVAT, with BiV showing superior reduction.
- BiV pacing significantly reduced IVD and altered LV activation patterns, unlike BiF pacing.
- Single-site LV pacing with fusion demonstrated comparable results to BiV pacing.
Conclusions:
- Biventricular pacing and single-site LV pacing with fusion induce significant ventricular activation changes.
- These modifications are crucial for achieving successful biventricular resynchronization.
- BiV pacing offers superior LVAT reduction and IVD shortening compared to other tested modes.