Acute Effects of Multisite Left Ventricular Pacing on Mechanical Dyssynchrony in Patients Receiving Cardiac Resynchronization Therapy
Abstract Background A novel quadripolar left ventricular (LV) pacing lead has the ability to deliver multisite LV pacing (MSLV). We set out to characterize the safety and changes in acute mechanical dyssynchrony with MSLV in cardiac resynchronization therapy (CRT) patients. Methods and Results Prosp...
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| Veröffentlicht in: | Journal of cardiac failure 2013-11, Vol.19 (11), p.731-738 |
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| creator | Rinaldi, C. Aldo, MD Kranig, Wolfgang, MD Leclercq, Christophe, MD, PhD Kacet, Salem, MD Betts, Tim, MD Bordachar, Pierre, MD Gutleben, Klaus-Jürgen, MD Shetty, Anoop, MD Keel, Allen, MS Ryu, Kyungmoo, PhD Farazi, Taraneh G., PhD SIMON, MARCUS, BSc Naqvi, Tasneem Z., MD |
| description | Abstract Background A novel quadripolar left ventricular (LV) pacing lead has the ability to deliver multisite LV pacing (MSLV). We set out to characterize the safety and changes in acute mechanical dyssynchrony with MSLV in cardiac resynchronization therapy (CRT) patients. Methods and Results Prospective multicenter study in 52 patients receiving CRT. An acute pacing protocol comprising 8 MSLV configurations covering a range of delays was compared with conventional CRT (baseline). Transthoracic tissue Doppler imaging (TDI) was used to measure the standard deviation of time to peak contraction of 12 LV segments (Ts-SD) and delayed longitudinal contraction. No ventricular arrhythmia occurred in any of the 52 patients. Complete TDI datasets were collected in 41 patients. Compared with baseline: 1) The mean Ts-SD was significantly lower for the optimal MSLV configuration (35.3 ± 36.4 vs 50.2 ± 29.1 ms; P < .001); 2) at least 1 MSLV configuration exhibited a significant dyssynchrony improvement in 63% of patients; and 3) the mean number of LV segments with delayed longitudinal contractions was significantly reduced with the optimal MSLV configuration (0.37 ± 7.99 vs 2.20 ± 0.19; P < .001). Conclusions Acute MSLV was acutely safe, and a proportion of MSLV vectors resulted in a significant reduction in echocardiographic dyssynchrony compared with conventional CRT. |
| doi_str_mv | 10.1016/j.cardfail.2013.10.003 |
| format | Article |
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Aldo, MD ; Kranig, Wolfgang, MD ; Leclercq, Christophe, MD, PhD ; Kacet, Salem, MD ; Betts, Tim, MD ; Bordachar, Pierre, MD ; Gutleben, Klaus-Jürgen, MD ; Shetty, Anoop, MD ; Keel, Allen, MS ; Ryu, Kyungmoo, PhD ; Farazi, Taraneh G., PhD ; SIMON, MARCUS, BSc ; Naqvi, Tasneem Z., MD</creator><creatorcontrib>Rinaldi, C. Aldo, MD ; Kranig, Wolfgang, MD ; Leclercq, Christophe, MD, PhD ; Kacet, Salem, MD ; Betts, Tim, MD ; Bordachar, Pierre, MD ; Gutleben, Klaus-Jürgen, MD ; Shetty, Anoop, MD ; Keel, Allen, MS ; Ryu, Kyungmoo, PhD ; Farazi, Taraneh G., PhD ; SIMON, MARCUS, BSc ; Naqvi, Tasneem Z., MD</creatorcontrib><description>Abstract Background A novel quadripolar left ventricular (LV) pacing lead has the ability to deliver multisite LV pacing (MSLV). We set out to characterize the safety and changes in acute mechanical dyssynchrony with MSLV in cardiac resynchronization therapy (CRT) patients. Methods and Results Prospective multicenter study in 52 patients receiving CRT. An acute pacing protocol comprising 8 MSLV configurations covering a range of delays was compared with conventional CRT (baseline). Transthoracic tissue Doppler imaging (TDI) was used to measure the standard deviation of time to peak contraction of 12 LV segments (Ts-SD) and delayed longitudinal contraction. No ventricular arrhythmia occurred in any of the 52 patients. Complete TDI datasets were collected in 41 patients. Compared with baseline: 1) The mean Ts-SD was significantly lower for the optimal MSLV configuration (35.3 ± 36.4 vs 50.2 ± 29.1 ms; P < .001); 2) at least 1 MSLV configuration exhibited a significant dyssynchrony improvement in 63% of patients; and 3) the mean number of LV segments with delayed longitudinal contractions was significantly reduced with the optimal MSLV configuration (0.37 ± 7.99 vs 2.20 ± 0.19; P < .001). Conclusions Acute MSLV was acutely safe, and a proportion of MSLV vectors resulted in a significant reduction in echocardiographic dyssynchrony compared with conventional CRT.</description><identifier>ISSN: 1071-9164</identifier><identifier>EISSN: 1532-8414</identifier><identifier>DOI: 10.1016/j.cardfail.2013.10.003</identifier><identifier>PMID: 24263116</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; biventricular pacing ; Cardiac resynchronization therapy ; Cardiac Resynchronization Therapy - methods ; Cardiovascular ; dyssynchrony ; Female ; heart failure ; Humans ; left ventricular pacing leads ; Male ; Middle Aged ; multisite pacing ; Myocardial Ischemia - diagnosis ; Myocardial Ischemia - physiopathology ; Myocardial Ischemia - therapy ; Prospective Studies ; Time Factors ; Treatment Outcome ; Ventricular Dysfunction, Left - diagnosis ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Dysfunction, Left - therapy ; Ventricular Function, Left - physiology</subject><ispartof>Journal of cardiac failure, 2013-11, Vol.19 (11), p.731-738</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c423t-1339bbed0f8a14da17bffe04530ba66bc8ffc372343ba7ba3ab580b68442085e3</citedby><cites>FETCH-LOGICAL-c423t-1339bbed0f8a14da17bffe04530ba66bc8ffc372343ba7ba3ab580b68442085e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1071916413011937$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24263116$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rinaldi, C. Aldo, MD</creatorcontrib><creatorcontrib>Kranig, Wolfgang, MD</creatorcontrib><creatorcontrib>Leclercq, Christophe, MD, PhD</creatorcontrib><creatorcontrib>Kacet, Salem, MD</creatorcontrib><creatorcontrib>Betts, Tim, MD</creatorcontrib><creatorcontrib>Bordachar, Pierre, MD</creatorcontrib><creatorcontrib>Gutleben, Klaus-Jürgen, MD</creatorcontrib><creatorcontrib>Shetty, Anoop, MD</creatorcontrib><creatorcontrib>Keel, Allen, MS</creatorcontrib><creatorcontrib>Ryu, Kyungmoo, PhD</creatorcontrib><creatorcontrib>Farazi, Taraneh G., PhD</creatorcontrib><creatorcontrib>SIMON, MARCUS, BSc</creatorcontrib><creatorcontrib>Naqvi, Tasneem Z., MD</creatorcontrib><title>Acute Effects of Multisite Left Ventricular Pacing on Mechanical Dyssynchrony in Patients Receiving Cardiac Resynchronization Therapy</title><title>Journal of cardiac failure</title><addtitle>J Card Fail</addtitle><description>Abstract Background A novel quadripolar left ventricular (LV) pacing lead has the ability to deliver multisite LV pacing (MSLV). We set out to characterize the safety and changes in acute mechanical dyssynchrony with MSLV in cardiac resynchronization therapy (CRT) patients. Methods and Results Prospective multicenter study in 52 patients receiving CRT. An acute pacing protocol comprising 8 MSLV configurations covering a range of delays was compared with conventional CRT (baseline). Transthoracic tissue Doppler imaging (TDI) was used to measure the standard deviation of time to peak contraction of 12 LV segments (Ts-SD) and delayed longitudinal contraction. No ventricular arrhythmia occurred in any of the 52 patients. Complete TDI datasets were collected in 41 patients. Compared with baseline: 1) The mean Ts-SD was significantly lower for the optimal MSLV configuration (35.3 ± 36.4 vs 50.2 ± 29.1 ms; P < .001); 2) at least 1 MSLV configuration exhibited a significant dyssynchrony improvement in 63% of patients; and 3) the mean number of LV segments with delayed longitudinal contractions was significantly reduced with the optimal MSLV configuration (0.37 ± 7.99 vs 2.20 ± 0.19; P < .001). Conclusions Acute MSLV was acutely safe, and a proportion of MSLV vectors resulted in a significant reduction in echocardiographic dyssynchrony compared with conventional CRT.</description><subject>Aged</subject><subject>biventricular pacing</subject><subject>Cardiac resynchronization therapy</subject><subject>Cardiac Resynchronization Therapy - methods</subject><subject>Cardiovascular</subject><subject>dyssynchrony</subject><subject>Female</subject><subject>heart failure</subject><subject>Humans</subject><subject>left ventricular pacing leads</subject><subject>Male</subject><subject>Middle Aged</subject><subject>multisite pacing</subject><subject>Myocardial Ischemia - diagnosis</subject><subject>Myocardial Ischemia - physiopathology</subject><subject>Myocardial Ischemia - therapy</subject><subject>Prospective Studies</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventricular Dysfunction, Left - diagnosis</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Dysfunction, Left - therapy</subject><subject>Ventricular Function, Left - physiology</subject><issn>1071-9164</issn><issn>1532-8414</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk9v1DAQxS0EoqXwFSofuWSZiZ0_e0FUS4FKW1FB4WrZzpj1kk0WO6kU7nxvnG6XA5eebD393ng8bxg7R1ggYPlmu7A6NE77dpEDiiQuAMQTdoqFyLNaonya7lBhtsRSnrAXMW4BoJZQPWcnucxLgViesj8XdhyIXzpHdoi8d_x6bAcffRLX5Ab-nboheDu2OvAbbX33g_cdvya70Z23uuXvpxinzm5C303cdwkafPJE_oUs-bvZsEqtem2TciT970SlOrcbCno_vWTPnG4jvXo4z9i3D5e3q0_Z-vPHq9XFOrMyF0OGQiyNoQZcrVE2GiuT-gZZCDC6LI2tnbOiyoUURldGC22KGkxZS5lDXZA4Y68Pdfeh_zVSHNTOR0ttqzvqx6hQligkYF0ktDygNvQxBnJqH_xOh0khqDkCtVXHCNQcwaynCJLx_OGN0eyo-Wc7zjwB7w4ApZ_eeQoq2jQxS40PKQTV9P7xN97-V8K2_j6OnzRR3PZj6NIcFaqYK1Bf50WY9wAFIC5FJf4CP7eyUQ</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>Rinaldi, C. Aldo, MD</creator><creator>Kranig, Wolfgang, MD</creator><creator>Leclercq, Christophe, MD, PhD</creator><creator>Kacet, Salem, MD</creator><creator>Betts, Tim, MD</creator><creator>Bordachar, Pierre, MD</creator><creator>Gutleben, Klaus-Jürgen, MD</creator><creator>Shetty, Anoop, MD</creator><creator>Keel, Allen, MS</creator><creator>Ryu, Kyungmoo, PhD</creator><creator>Farazi, Taraneh G., PhD</creator><creator>SIMON, MARCUS, BSc</creator><creator>Naqvi, Tasneem Z., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20131101</creationdate><title>Acute Effects of Multisite Left Ventricular Pacing on Mechanical Dyssynchrony in Patients Receiving Cardiac Resynchronization Therapy</title><author>Rinaldi, C. Aldo, MD ; Kranig, Wolfgang, MD ; Leclercq, Christophe, MD, PhD ; Kacet, Salem, MD ; Betts, Tim, MD ; Bordachar, Pierre, MD ; Gutleben, Klaus-Jürgen, MD ; Shetty, Anoop, MD ; Keel, Allen, MS ; Ryu, Kyungmoo, PhD ; Farazi, Taraneh G., PhD ; SIMON, MARCUS, BSc ; Naqvi, Tasneem Z., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c423t-1339bbed0f8a14da17bffe04530ba66bc8ffc372343ba7ba3ab580b68442085e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>biventricular pacing</topic><topic>Cardiac resynchronization therapy</topic><topic>Cardiac Resynchronization Therapy - methods</topic><topic>Cardiovascular</topic><topic>dyssynchrony</topic><topic>Female</topic><topic>heart failure</topic><topic>Humans</topic><topic>left ventricular pacing leads</topic><topic>Male</topic><topic>Middle Aged</topic><topic>multisite pacing</topic><topic>Myocardial Ischemia - diagnosis</topic><topic>Myocardial Ischemia - physiopathology</topic><topic>Myocardial Ischemia - therapy</topic><topic>Prospective Studies</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventricular Dysfunction, Left - diagnosis</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>Ventricular Dysfunction, Left - therapy</topic><topic>Ventricular Function, Left - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rinaldi, C. Aldo, MD</creatorcontrib><creatorcontrib>Kranig, Wolfgang, MD</creatorcontrib><creatorcontrib>Leclercq, Christophe, MD, PhD</creatorcontrib><creatorcontrib>Kacet, Salem, MD</creatorcontrib><creatorcontrib>Betts, Tim, MD</creatorcontrib><creatorcontrib>Bordachar, Pierre, MD</creatorcontrib><creatorcontrib>Gutleben, Klaus-Jürgen, MD</creatorcontrib><creatorcontrib>Shetty, Anoop, MD</creatorcontrib><creatorcontrib>Keel, Allen, MS</creatorcontrib><creatorcontrib>Ryu, Kyungmoo, PhD</creatorcontrib><creatorcontrib>Farazi, Taraneh G., PhD</creatorcontrib><creatorcontrib>SIMON, MARCUS, BSc</creatorcontrib><creatorcontrib>Naqvi, Tasneem Z., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiac failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rinaldi, C. Aldo, MD</au><au>Kranig, Wolfgang, MD</au><au>Leclercq, Christophe, MD, PhD</au><au>Kacet, Salem, MD</au><au>Betts, Tim, MD</au><au>Bordachar, Pierre, MD</au><au>Gutleben, Klaus-Jürgen, MD</au><au>Shetty, Anoop, MD</au><au>Keel, Allen, MS</au><au>Ryu, Kyungmoo, PhD</au><au>Farazi, Taraneh G., PhD</au><au>SIMON, MARCUS, BSc</au><au>Naqvi, Tasneem Z., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute Effects of Multisite Left Ventricular Pacing on Mechanical Dyssynchrony in Patients Receiving Cardiac Resynchronization Therapy</atitle><jtitle>Journal of cardiac failure</jtitle><addtitle>J Card Fail</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>19</volume><issue>11</issue><spage>731</spage><epage>738</epage><pages>731-738</pages><issn>1071-9164</issn><eissn>1532-8414</eissn><abstract>Abstract Background A novel quadripolar left ventricular (LV) pacing lead has the ability to deliver multisite LV pacing (MSLV). We set out to characterize the safety and changes in acute mechanical dyssynchrony with MSLV in cardiac resynchronization therapy (CRT) patients. Methods and Results Prospective multicenter study in 52 patients receiving CRT. An acute pacing protocol comprising 8 MSLV configurations covering a range of delays was compared with conventional CRT (baseline). Transthoracic tissue Doppler imaging (TDI) was used to measure the standard deviation of time to peak contraction of 12 LV segments (Ts-SD) and delayed longitudinal contraction. No ventricular arrhythmia occurred in any of the 52 patients. Complete TDI datasets were collected in 41 patients. Compared with baseline: 1) The mean Ts-SD was significantly lower for the optimal MSLV configuration (35.3 ± 36.4 vs 50.2 ± 29.1 ms; P < .001); 2) at least 1 MSLV configuration exhibited a significant dyssynchrony improvement in 63% of patients; and 3) the mean number of LV segments with delayed longitudinal contractions was significantly reduced with the optimal MSLV configuration (0.37 ± 7.99 vs 2.20 ± 0.19; P < .001). Conclusions Acute MSLV was acutely safe, and a proportion of MSLV vectors resulted in a significant reduction in echocardiographic dyssynchrony compared with conventional CRT.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24263116</pmid><doi>10.1016/j.cardfail.2013.10.003</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged biventricular pacing Cardiac resynchronization therapy Cardiac Resynchronization Therapy - methods Cardiovascular dyssynchrony Female heart failure Humans left ventricular pacing leads Male Middle Aged multisite pacing Myocardial Ischemia - diagnosis Myocardial Ischemia - physiopathology Myocardial Ischemia - therapy Prospective Studies Time Factors Treatment Outcome Ventricular Dysfunction, Left - diagnosis Ventricular Dysfunction, Left - physiopathology Ventricular Dysfunction, Left - therapy Ventricular Function, Left - physiology |
| title | Acute Effects of Multisite Left Ventricular Pacing on Mechanical Dyssynchrony in Patients Receiving Cardiac Resynchronization Therapy |
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