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Updated: Oct 10, 2025
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Optocardiography and Electrophysiology Studies of Ex Vivo Langendorff-perfused Hearts
Published on: November 7, 2019
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Electrogram analysis to detect cathodal and anodal capture in left ventricular cardiac resynchronization pacing leads
Cameron Pfeffer1, Michael Fryer2, Jing Xian Quah3
1Electrophysiology, Abbott Laboratories, Brisbane, Queensland, Australia.
Pacing and Clinical Electrophysiology : PACE
|December 8, 2021
Summary
Electrogram (EGM) analysis reliably detects cardiac resynchronization therapy (CRT) lead capture modes (cathodal, anodal, or simultaneous) with higher sensitivity than electrocardiogram (ECG) changes, aiding CRT optimization.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Cardiac resynchronization therapy (CRT) is crucial for heart failure management.
- Optimizing pacing lead function in CRT is essential for patient outcomes.
- Understanding capture modes in left ventricular (LV) quadripolar leads is key.
Purpose of the Study:
- To identify electrogram (EGM) characteristics for detecting cathodal, anodal, or simultaneous capture in LV quadripolar pacing leads.
- To examine the relationship between EGM characteristics and electrocardiogram (ECG) changes during CRT optimization.
Main Methods:
- Retrospective analysis of 54 bipolar pacing configurations in nine CRT patients.
- Performed unipolar (cathode/anode) and bipolar pacing tests.
- Analyzed ECG and EGM morphology and amplitude changes during voltage stepdown.
Main Results:
- EGM morphology reliably indicated unipolar capture modes (98% sensitivity).
- Sudden EGM amplitude increases during bipolar LV capture testing signaled capture mode transitions.
- EGM transitions correlated with ECG changes in 90% of cases.
Conclusions:
- EGM characteristics accurately detect capture modes in LV quadripolar leads.
- EGM analysis offers greater sensitivity than ECG for identifying capture modes.
- Integrating EGM analysis into CRT follow-up can enhance device efficacy.
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