Multi-point pacing resulted in more rapid left ventricular activation compared to standard CRT in 2 of 5 patients, demonstrating highly idiosyncratic and patient-specific electrical responses.
Observational (n=5)
Does multi-point pacing optimization using non-invasive electrocardiographic imaging improve acute electrical resynchronization compared to standard CRT?
Non-invasive ECG imaging demonstrates that the acute electrical effects of multi-point pacing in CRT are highly patient-specific and potentially limited by extensive LV scarring.
AIM: Quadripolar lead technology and multi-point pacing (MPP) are important clinical adjuncts in cardiac resynchronization therapy (CRT) pacing aimed at reducing the rate of non-response to therapy. Mixed results have been achieved using MPP and it is critical to identify which patients require this approach and how to configure their MPP stimulation, in order to achieve optimal electrical resynchronization. METHODS however, in the remaining three patients, the use of MPP did not appear to acutely improve electrical resynchronization. Crucially, this cohort showed evidence of extensive LV scarring which was well visualized using both CMR and ECGi voltage mapping. CONCLUSIONS: Our work suggests a potential role for ECGi in the optimization of non-responders to CRT, as it allows the fusion of activation maps and scar analysis above and beyond interrogation of the 12 lead ECG.
Sieniewicz et al. (Mon,) conducted a observational in Cardiac resynchronization therapy (CRT) (n=5). Multi-point pacing (MPP) guided by non-invasive electrocardiographic imaging (ECGi) vs. Standard CRT was evaluated on Electrical resynchronization (left ventricular activation). Multi-point pacing resulted in more rapid left ventricular activation compared to standard CRT in 2 of 5 patients, demonstrating highly idiosyncratic and patient-specific electrical responses.