Vectorcardiography for Optimization of Stimulation Intervals in Cardiac Resynchronization Therapy

• DOI: 10.1007/s12265-015-9615-7
• Publication Date: 2015-03-05T20:30:20Z
• Authors: Caroline J. M. va...; Liliane Wecke; Wouter M. van Eve...; Marcus Ståhlberg; Michel H. G. Janssen; Frieder Braunschweig; Lennart Bergfeldt; Harry J. G. M. Cr...; Kevin Vernooy; Frits W. Prinzen
• Keywords: Vectorcardiography; Bundle branch block

Current optimization of atrioventricular (AV) and interventricular (VV) intervals in cardiac resynchronization therapy (CRT) is time consuming subject to noise. We aimed prove the principle that best hemodynamic effect CRT achieved by cancelation opposing electrical forces, detectable from QRS morphology 3D vectorcardiogram (VCG). Different degrees left (LV) right ventricular (RV) pre-excitation were induced, using variation AV during LV pacing 20 patients with bundle branch block (LBBB) VV biventricular 18 complete or atrial fibrillation. The smallest vector area identified stimulation minimal systolic stretch (median difference [IQR] ms [−20, ms] maximal response (10 40 ms]). Reliability VCG measurements was superior measurements. This study proves analysis may allow easy reliable patients.