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The interventricular conduction delays guide best cardiac resynchronization therapy: A tailored-patient approach to
Amato Santoro1, Maria Barilli2, Carmine Marallo2
1Division of Cardiology, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Insights
Conduction intervals can predict Cardiac Resynchronization Therapy (CRT) success. Measuring interventricular conduction delays during biventricular pacing or Conduction System Pacing guides CRT strategy for improved outcomes.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Predicting Cardiac Resynchronization Therapy (CRT) success using conduction intervals in biventricular pacing (BiVP) or Conduction System Pacing (CSP) is not widely adopted.
- Intrinsic conduction intervals (RVs-LVs > 70 ms) and paced intervals (RVp-LVs) can indicate potential CRT response.
Abstract:
Evaluation of conduction intervals to predict success of resynchronization in biventricular pacing(BiVP) or Conduction System Pacing(CSP) is not spread in clinical practice. A right ventricle-to-left ventricle intrinsic conduction interval (RVs-LVs) > 70 ms or prolonged RVpaced - LVs(RVp-LVs)interval can predict Cardiac Resynchronization Therapy (CRT)response.This paper describes a case of cardiac resynchronization guided by spontaneous and paced interventricular conduction delays (IVCD) obtained in BiVP that led to changing intraoperative approach. A strategy for cardiac resynchronization based on the CSP/BiVP approach according to the IVCD could represent a viable and reliable solution to obtain a narrow paced QRS and to improve the CRT response.
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