Pacing prescription for cardiac resynchronization therapy: When RV stimulation matters

被引：4

作者：

Varma, Niraj ^{[1
]}

Ghanem, Raja ^{[2
]}

Jia, Ping ^{[2
]}

机构：

[1] Univ Hosp, Cardiac Electrophysiol Sect, Dept Cardiol, Cleveland, OH USA

[2] Case Western Reserve Univ, Cardiac Bioelect Res & Training Ctr, Biomed Engn, Cleveland, OH 44106 USA

来源：

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY | 2019年 / 30卷 / 05期

基金：

美国国家卫生研究院;

关键词：

CRT; electrical resynchronization; RV pacing; HEART-FAILURE; ACTIVATION;

D O I：

10.1111/jce.13850

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Cardiac resynchronization therapy (CRT) aims to correct delayed left ventricle (LV) activation resulting from left bundle branch block (LBBB). The source of LV activation delay resides in the septum and/or anterior LV. LV pacing, timed with intrinsic right bundle branch (RBB) conduction, may restore "physiological" biventricular activation. This is not assured because LV paced wavefronts themselves propagate unpredictably. Less studied are effects of right ventricle (RV) pacing on LV activation in heart failure (HF) patients with LBBB. Methods and Results In this case RV pacing pre-excited precisely the region left behind during LV pacing. Consequently, biventricular pacing produced confluent LV depolarization (the patient "responded" to this with reverse remodeling). Conclusion Successful electrical resynchronization requires best combination and timing of paced/intrinsic wavefront(s). This demands individualization. Sometimes, an RV paced wavefront may be valuable to resynchronization.

引用

页码：769 / 770

页数：2

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