Key result
In a single patient with left bundle branch block, MultiPoint Pacing combined with the SyncAV Plus algorithm reduced QRS duration by 32% (from 178 ms to 121 ms) compared to intrinsic conduction.
Why the study?
Response to CRT depends on factors such as AV delay and lead location, but selecting optimal settings remains challenging despite advances in quadripolar leads and device algorithms.
Case Report (n=1)
Demonstrates the use of noninvasive electrocardiographic imaging for dynamic AV delay programming in a patient with LBBB.
Should not yet change CRT programming in LBBB; hypothesis-generating for combined MultiPoint Pacing and SyncAV algorithms.
The response to cardiac resynchronization therapy (CRT) is determined by various factors, including left ventricular (LV) lead location, atrioventricular (AV) delay, and inter-/intraventricular delays. Advances in quadripolar lead technology and device algorithms have improved patient response, yet selection of optimal settings remains challenging. Studies have shown acute improvement in electrical synchrony with manual AV optimization by fusion optimized intervals1,2; automated device algorithms, for example AdaptivCRT (Medtronic, Minneapolis, MN),3 SmartDelay (Boston Scientific, Marlborough, MA),4 and SyncAVTM (Abbott, Sylmar, CA)5; and pacing from multiple LV lead electrodes with MultiPoint Pacing (MPP).
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Waddingham et al. (2021) conducted a case report in Ischemic cardiomyopathy with left bundle branch block and heart failure (n=1). SyncAV Plus algorithm with MultiPoint Pacing (MPP) vs. Intrinsic conduction was evaluated on QRS duration (QRSd) (32% reduction). In a single patient with left bundle branch block, MultiPoint Pacing combined with the SyncAV Plus algorithm reduced QRS duration by 32% (from 178 ms to 121 ms) compared to intrinsic conduction.
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