Vera Stepanova
North-Western State Medical University, Russian FederationTitle: Preoperative prediction of optimal method and site of left ventricular lead implantation to increase CRT response rate
Abstract
Aim: To evaluate benefit of target left ventricular lead implantation in electrically latest site of left ventricle defined by the noninvasive mapping method versus standard implant procedure in aspect of response to cardiac resynchronization therapy (CRT). Also, to reveal the impact of distance «left ventricular lead — latest electrical activation site» on the response to CRT.
Methods: In a prospective study two groups of patients with I and II «a» classes of indications for CRT, according to 2021 European Cardiologic Society guidelines on cardiac pacing and CRT, were evaluated. The main group included 60 patients who underwent noninvasive electrophysiological mapping using Amycard 01 C system in combination with heart computed tomography with contrasting to determine the latest electrical activation site and the vein of coronary sinus the closest to that site before left ventricular lead implantation. The control group included 60 patients who underwent standard left ventricular lead implantation without prior noninvasive electrophysiological mapping. The response to CRT was compared between the main and the control groups based on standard efficiency criteria. The distance «left ventricular lead — latest electrical activation site» was defined as distance from the stimulating pole of the left ventricular lead to the latest electrical activation site of the left ventricle during the initial rhythm. Then response to CRT was evaluated considering this parameter in both groups.
Results: The contingency analysis of the response to CRT depending on the group revealed significant differences in the percentage of responders to CRT between the main and the control groups (85% versus 63% respectively, p <0,01). The analysis of the response to CRT considering the distance «left ventricular lead — latest electrical activation site» showed a significant impact of this parameter: the threshold limit value of responding to CRT was <45 mm (p <0,01).
Conclusions: Target implantation of the left ventricular lead to the latest electrical activation site, detected noninvasively, has a significant evaluating impact on the response to CRT. The distance «left ventricular lead — latest electrical activation site» <45mm is critical for the response to CRT.
Biography
To be updated soon...
Organization Location
1309 Coffeen Avenue, STE 1200, Sheridan, Wyoming 82801, USA
Mail us at
Program Enquiry
heart@scientexconferences.com
General Enquiry
contact@scientexconferences.com
Registration Enquiry
finance@scientexconferences.com
heart@scientexconferences.com
Our Social Presence
Call us at
USA :(+1) 929 224 5068