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Related Experiment Video

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Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

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Anodal capture in cardiac resynchronization therapy implications for device programming.

David Tamborero¹, Lluis Mont, Roberto Alanis

¹Thorax Institute, Hospital Clínic, University of Barcelona, and Institut de Investigació, Biomèdica August Pi i Sunyer (IDIBAPS), Catalonia, Spain. dtambore@clinic.ub.es

Pacing and Clinical Electrophysiology : PACE

|September 20, 2006

Summary

Right ventricular anodal capture (AC) during cardiac resynchronization therapy (CRT) can achieve narrower QRS widths than biventricular pacing. This finding offers new insights for optimizing CRT device programming.

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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Published on: December 11, 2017

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Last Updated: Jul 20, 2026

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Area of Science:

Cardiology
Electrophysiology
Medical Devices

Background:

Anodal capture (AC) in the right ventricle (RV) can occur during cardiac resynchronization therapy (CRT) when left ventricular (LV) pacing uses a pseudobipolar configuration.
Understanding AC prevalence and its impact on device programming is crucial for effective CRT.

Purpose of the Study:

To analyze the prevalence of RV anodal capture (AC) in patients undergoing CRT.
To evaluate the implications of AC on device programming and QRS morphology.

Main Methods:

Evaluated QRS morphology in three pacing modes: LV tip pacing plus RV AC, biventricular (BiV) pacing, and BiV pacing plus RV AC.
Tested various interventricular (VV) intervals, from LV preactivation to RV preactivation, in BiV pacing modes.
Assessed AC in 38 consecutive patients, noting device type and pacing configurations.

Main Results:

AC was achieved in 14 out of 38 patients (37%), predominantly with pacemakers (74%) and not defibrillators.
LV tip pacing plus RV AC resulted in narrower QRS durations compared to BiV pacing in 50% of patients with AC.
BiV pacing combined with RV AC generated ventricular depolarization via two wavefronts, despite three stimulation sites.

Conclusions:

Right ventricular anodal capture achieved the narrowest QRS durations across all tested pacing modes in a significant portion of CRT patients.
ECG analysis revealed two wavefronts of ventricular activation even when pacing involved three sites (BiV pacing plus RV AC).