ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023
Non-invasive three-dimensional electrical activation mapping to predict cardiac resynchronization therapy response: site of latest left ventricular activation relative to pacing site.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure.Heart rhythm · 2023Guideline
- Targeted left ventricular lead positioning to the site of latest activation in cardiac resynchronization therapy: a systematic review and meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Pooled it
- Computational Modelling of Selective Capture Mechanisms in Conduction System Pacing.Annals of biomedical engineering · 2026Article
- Personalized Test Bolus MSCT Protocol for Optimal Coronary Sinus Venous Visualization in Candidates for Cardiac Resynchronization Therapy.Journal of clinical medicine · 2026Article
- Refining Left Bundle Branch Block Activation Criteria in CRT Candidates: A Noninvasive Electrocardiographic Imaging Study.Diagnostics (Basel, Switzerland) · 2026Article
- High frame rate speckle tracking echocardiography to image the left ventricular mechanical activation sequence in healthy participants and patients with left bundle branch block.European heart journal. Imaging methods and practice · 2026Article
- Noninvasive Cardiac Electrical Activity Mapping Systems: Current Available Options.Reviews in cardiovascular medicine · 2025Review
- Implementation of lead V8 as a simple non-invasive tool to improve patient selection in cardiac resynchronization therapy and guide left ventricular lead placement.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Vectorcardiography in CRT: What We Know and What There Is to Learn.Journal of cardiovascular development and disease · 2025Review
- Agreement on site of latest electrical activation between right ventricular pacing and intrinsic conduction as target for left ventricular lead position in cardiac resynchronization therapy.Heart rhythm O2 · 2025Article
- Multipoint Left Ventricular Pacing as Alternative Approach in Cases of Biventricular Pacing Failure.Journal of clinical medicine · 2025Review
- New Pacing Techniques and Non-Invasive Methods That May Improve Response to Cardiac Resynchronization Therapy.Journal of cardiovascular development and disease · 2024Article
- Concepts of Cardiac Dyssynchrony and Dynamic Approach.Diagnostics (Basel, Switzerland) · 2024Review
- Current Role of Electrocardiographic Imaging in Patient Selection for Cardiac Resynchronization Therapy.Journal of cardiovascular development and disease · 2024Review
- Prognostic implications of invasive hemodynamics during cardiac resynchronization therapy: Stroke work outperforms dP/dtHeart rhythm O2 · 2023Article
- Cardiac magnetic resonance-derived myocardial scar is associated with echocardiographic response and clinical prognosis of left bundle branch area pacing for cardiac resynchronization therapy.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Progress in Cardiac Resynchronisation Therapy and Optimisation.Journal of cardiovascular development and disease · 2023Review
- 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure.Journal of arrhythmia · 2023Article
- The evolving state of cardiac resynchronization therapy and conduction system pacing: 25 years of research at EP Europace journal.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Review
- Combination of personalized computational modeling and machine learning for optimization of left ventricular pacing site in cardiac resynchronization therapy.Frontiers in physiology · 2023Article
Corrections and comments
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Authors and funding
28 authors.
Funding
Abstract
aimsPacing remote from the latest electrically activated site (LEAS) in the left ventricle (LV) may diminish response to cardiac resynchronization therapy (CRT). We tested whether proximity of LV pacing site (LVPS) to LEAS, determined by non-invasive three-dimensional electrical activation mapping [electrocardiographic Imaging (ECGI)], increased likelihood of CRT response. METHODS AND
resultsConsecutive CRT patients underwent ECGI and chest/heart computed tomography 6-24 months of post-implant. Latest electrically activated site and the distance to LVPS (dp) were assessed. Left ventricular end-systolic volume (LVESV) reduction of ≥15% at clinical follow-up defined response. Logistic regression probabilistically modelled non-response; variables included demographics, heart failure classification, left bundle branch block (LBBB), ischaemic heart disease (IHD), atrial fibrillation, QRS duration, baseline ejection fraction (EF) and LVESV, comorbidities, use of CRT optimization algorithm, angiotensin-converting enzyme inhibitor(ACE)/angiotensin-receptor blocker (ARB), beta-blocker, diuretics, and dp. Of 111 studied patients [64 ± 11 years, EF 28 ± 6%, implant duration 12 ± 5 months (mean ± SD), 98% had LBBB, 38% IHD], 67% responded at 10 ± 3 months post CRT-implant. Latest electrically activated sites were outside the mid-to-basal lateral segments in 35% of the patients. dp was 42 ± 23 mm [31 ± 14 mm for responders vs. 63 ± 24 mm non-responders (P < 0.001)]. Longer dp and the lack of use of CRT optimization algorithm were the only independent predictors of non-response [area under the curve (AUC) 0.906]. dp of 47 mm delineated responders and non-responders (AUC 0.931).
conclusionThe distance between LV pacing site and latest electrical activation is a strong independent predictor for CRT response. Non-invasive electrical evaluation to characterize intrinsic activation and guide LV lead deployment may improve CRT efficacy.
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