Shortening of paced QRS duration after electrocardiographic optimization of left ventricular pacing vector in
Casper Lund-Andersen1, Helen H Petersen1, Christian Jøns1
1Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen East, Denmark.
Background:
Choice of left ventricular pacing vector (LVPV) affects the QRS-duration (QRSd) in patients with Cardiac Resynchronization Therapy (CRT). It is not known whether testing all LVPVs reduces QRSd compared to device-based “standard-programming”.
Methods:
In patients implanted with CRT several ECGs were recorded for each usable LVPV (no phrenic nerve stimulation and threshold <3.5 V) and during “standard-programming” after device-based optimization of AV/VV delays.
Results:
22 consecutive patients were included. Average QRSd reduction after CRT + “standard-programming” was 27.3 ± 22 ms. Additional QRSd-reduction was possible in 4 patients by changing the LVPV, and in 5 other patients after optimization of AV- and VV delays without changing LVPV.
Conclusions:
Shortening of QRSd compared to “standard-programming” was possible approximately 40% of these patients treated with CRT by testing all LVPVs and re-optimizing AV/VV delays during follow-up. Studies of clinical effects are needed.
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