Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?

Detalhes bibliográficos
Autor(a) principal: Goncalves, I. S. S.
Data de Publicação: 2018
Outros Autores: Marques, P., Hyde Congo, K., Ribeiro Agostinho, João Pedro, Aguiar-Ricardo, Inês, Rigueira, Joana, Nunes-Ferreira, Afonso, Santos, R., Sousa, Joana
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10451/40044
Resumo: © The European Society of Cardiology 2018. All rights reserved.
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spelling Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?© The European Society of Cardiology 2018. All rights reserved.Introduction: The most recent studies in cardiac resynchronization therapy (CRT) have been focused on attempts to improve response rate, such as the determination of the optimal placement of the left ventricular (LV) lead. The position of the LV lead guided by the site of latest electrical delay (ED), seems to be a promising strategy. The same strategy may be useful in assessing the ideal positioning of right ventricular (RV) lead in CRT. Purpose: To determine the most favorable position of the RV lead (septal versus apical) in CRT, by measuring the ED of the LV poles during septal or apical RV pacing in patients with triple-site CRT (TRIV). Methods: A single-center prospective study of consecutive patients (Oct. 2014 to Oct. 2017) submited to CRT device implantation (Quadra Allure MPTM, which allows post-implantation ED measurement) in TRIV mode - with a quadripolar lead in the LV, a RV lead positioned at the septum and a RV lead at the apex. In the follow-up, the lead position was confirmed and determined by fluoroscopic evaluation (anterior, lateral and postero-lateral in the short axis and basal, mid and apical on the long axis). The ED was measured at the 4-pole LV lead, during apical and septal RV pacing and the relation between the ED and lead position was evaluated. Results: Twenty two patients were included: 82% male, median age 78 years; 50% implanted CRT with defibrillator; 27% had ischemic heart disease and 73% non-ischemic etiology; all patients had permanent atrial fibrillation and the QRS duration was of 176±29ms. The position of the LE lead poles was classified as lateral in 44% and postero-lateral in 56%, basal in 28%, medial in 39% and apical in 34%. We evaluated 160 ED. The mean ED between the apical RV lead and the LV poles was significantly higher than the delay between septal RV lead and the LV poles [161±33ms vs 75±45ms (p<0.001)]. This difference remained significant in LV poles located in a lateral position (76±62 vs. 166±36ms; p<0.001) or in a postero-lateral position (74±30 vs. 157±31ms; p<0.001); the same ocurred for LV poles in a basal (99±62 vs. 179±24ms, p<0.001), mid (72±38 vs. 167±31ms, p<0.001) and apical location (57±24 vs. 140±32ms, p<0.001). Conclusion: The LV lead position is an important determinant of the success of CRT, but is conditioned by anatomical and technical characteristics. The optimization of CRT may then depend on the positioning of RV lead. This study demonstrated that the apical (vs. septal) RV lead positioning presents higher ED in relation to LV lead, regardless of the latter position.Oxford University PressRepositório da Universidade de LisboaGoncalves, I. S. S.Marques, P.Hyde Congo, K.Ribeiro Agostinho, João PedroAguiar-Ricardo, InêsRigueira, JoanaNunes-Ferreira, AfonsoSantos, R.Sousa, Joana2019-11-04T16:12:08Z20182018-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/40044engEuropean Heart Journal, Volume 39, Issue suppl_1, August 2018, ehy566.P57410195-668X10.1093/eurheartj/ehy566.P5741info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T16:39:05Zoai:repositorio.ul.pt:10451/40044Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:53:46.114921Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?
title Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?
spellingShingle Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?
Goncalves, I. S. S.
title_short Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?
title_full Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?
title_fullStr Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?
title_full_unstemmed Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?
title_sort Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?
author Goncalves, I. S. S.
author_facet Goncalves, I. S. S.
Marques, P.
Hyde Congo, K.
Ribeiro Agostinho, João Pedro
Aguiar-Ricardo, Inês
Rigueira, Joana
Nunes-Ferreira, Afonso
Santos, R.
Sousa, Joana
author_role author
author2 Marques, P.
Hyde Congo, K.
Ribeiro Agostinho, João Pedro
Aguiar-Ricardo, Inês
Rigueira, Joana
Nunes-Ferreira, Afonso
Santos, R.
Sousa, Joana
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Goncalves, I. S. S.
Marques, P.
Hyde Congo, K.
Ribeiro Agostinho, João Pedro
Aguiar-Ricardo, Inês
Rigueira, Joana
Nunes-Ferreira, Afonso
Santos, R.
Sousa, Joana
description © The European Society of Cardiology 2018. All rights reserved.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018-01-01T00:00:00Z
2019-11-04T16:12:08Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/40044
url http://hdl.handle.net/10451/40044
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv European Heart Journal, Volume 39, Issue suppl_1, August 2018, ehy566.P5741
0195-668X
10.1093/eurheartj/ehy566.P5741
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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