Key result
Longer intrinsic RV-to-LV delay and shorter delta-LV on implant electrograms predict 3-month CRT response.
Why the study?
Do intra-procedural intracardiac electrogram measurements (such as intrinsic RV-to-LV delay and delta-LV) at implant predict 3-month clinical and echocardiographic response to cardiac resynchronization therapy in heart failure patients?
Cohort (n=41)
No
Do intra-procedural intracardiac electrogram measurements (such as intrinsic RV-to-LV delay and delta-LV) at implant predict 3-month clinical and echocardiographic response to cardiac resynchronization therapy in heart failure patients?
Intra-procedural intracardiac electrogram measurements of longer intrinsic RV-to-LV delay (>100 ms) and shorter paced conduction difference (delta-LV <40 ms) predict 3-month CRT response even when the LV lead is placed in the echocardiographically targeted segment of latest mechanical activation.
Answers are grounded in this paper and cite their sources.
Implant RV-to-LV delay and delta-LV measurements were associated with CRT response; extends prior electrical predictors but leaves open randomized validation before guiding lead placement.
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Lin et al. (2014) conducted a cohort in Symptomatic heart failure undergoing cardiac resynchronization therapy (n=41). Intrinsic RV-to-LV electrical delay (int RV-LV > 100 ms) and paced conduction difference (delta-LV < 40 ms) on intracardiac electrograms vs. Int RV-LV < 100 ms and delta-LV > 40 ms was evaluated on Response to CRT (combined endpoint of improvement in LVEF > 10%, reduction in LVEDD > 15%, and improvement of >= 1 NYHA class) (p=<0.05). Longer intrinsic RV-to-LV delay (101 vs 78 ms, p<0.05) and shorter delta-LV (21 vs 51 ms, p<0.05) on implant intracardiac electrograms predicted 3-month CRT response.
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