Feasibility of cathodic-anodal left ventricular stimulation for alternative multisite pacing
Gabriele Dell'Era1, Federica De Vecchi2, Eleonora Prenna1
1Department of Cardiology, University Hospital 'Maggiore della Carita`', Novara, Italy.
Background:
Simultaneous cathodic-anodal capture by a bipole of a cardiac resynchronization therapy (CRT) left-ventricular (LV) catheter may depolarize a larger LV area than conventional multipoint pacing. We evaluated the feasibility of cathodic-anodal LV stimulation.
Methods:
In 30 patients undergoing CRT with a quadripolar LV lead, we evaluated the cathodic and anodal capture threshold for each LV pole and compared QRS on electrocardiogram (ECG) during single-point cathodic biventricular stimulation (S-BS), multipoint BS (M-BS), and cathodic-anodal BS (CA-BS).
Results:
Anodal capture was obtained by three poles in 23/30 patients, by two poles in five, and was not feasible in two. The mean single-point anodal threshold was 3.93 V versus single-point cathodic threshold of 1.95 V. On comparing ECGs, M-BS and CA-BS produced similar QRS wavefront activation in 90% of patients.
Conclusions:
CA-BS is feasible and may be used in LV pacing to achieve a different wavefront of electrical activation. Further prospective studies are needed in order to verify the clinical impact of this kind of stimulation.
Related Concept Videos
Alternative RNA Splicing
There are five types of alternative RNA splicing that vary in the ways the pre-mRNA segments are removed or retained in the mature mRNA. The first...
Alternative RNA Splicing
Null and Alternative Hypotheses
The null hypothesis, denoted by H0 is a statement of no difference between the variables—they are not related. This can often be considered the status quo. As a result if you cannot accept the null, it requires some action.
The alternative hypothesis, denoted by H1 or Ha, is a claim about the...
Electric Generator: Alternator
The magnetic flux passing through the coil varies sinusoidally as the loop rotates inside the magnetic field. This...
Alternative Sets of Equilibrium Equations
One example of such a situation can be observed in a...
Area Computation by the Alternative Coordinate Method


