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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
Longer Baseline Left Ventricular Activation Time Is Associated With Lower Mortality and Lower Risk of Heart Failure
Sofia Marinko1, Pyotr G Platonov1,2, Rasmus Borgquist1
1Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
Summary
A longer baseline left ventricular activation time (LVAT) measured by electrocardiogram (ECG) is linked to better outcomes for cardiac resynchronization therapy (CRT). This finding may improve patient selection for CRT.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Cardiac resynchronization therapy (CRT) effectiveness varies among patients.
- Current selection criteria for CRT may not identify all suitable candidates.
- Left ventricular activation time (LVAT) is a potential marker for CRT response.
Purpose of the Study:
- To investigate the association between pre-implant LVAT and clinical outcomes in patients receiving CRT.
- To determine if LVAT measured by standard 12-lead ECG can predict CRT response.
Main Methods:
- Retrospective analysis of 415 patients who underwent CRT implantation.
- Measurement of LVAT from pre- and post-implant digital ECGs.
- Primary endpoint: heart failure hospitalization or all-cause mortality.
Main Results:
- A longer pre-implant LVAT was associated with a reduced risk of the primary endpoint in patients with left bundle branch block (LBBB).
- Post-implant LVAT did not show a significant association with clinical outcomes.
- The study included patients with a median age of 72.8 years and LVEF of 27.5%.
Conclusions:
- Baseline LVAT may serve as a predictor of CRT response.
- A longer pre-implant LVAT is associated with lower heart failure hospitalization and mortality risk.
- Further prospective studies are warranted to validate LVAT in CRT patient selection.
