Document Detail

Noncontact mapping of left ventricle during CRT implant.
MedLine Citation:
PMID:  19821940     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Not all candidates for cardiac resynchronization therapy (CRT) are responders at follow-up. Echocardiographic parameters of dyssynchrony do not predict the response. Analysis of electrical properties of left ventricle (LV) by noncontact mapping (NCM) could be useful to better identify candidates for CRT. METHODS AND RESULTS: We studied nine consecutive patients undergoing CRT. An NCM was positioned in the LV via atrial transeptal puncture. LV activation was recorded during sinus rhythm (SR), pacing from RV, from different LV epicardial locations, and in biventricular (BIV) pacing. The corresponding invasive pressure was determined. Heparin, administered during NCM, was reversed and CRT implant was completed. An offline analysis of the data was performed in order to measure transeptal and total LV activation time, to evaluate the site of earliest and latest LV activation, and the pattern of activation. No complications occurred. Mean time of total NCM procedures was 24 + or - 7 minutes. During SR, RV, LV, and BIV pacing, respectively, a "U"-shaped LV activation pattern was found in three, seven, four, and and two patients; mean LV activation time was 58.1 + or - 7.0, 81.7 + or - 15.8, 71.1 + or - 12.4, and 65.6 + or - 7.7 ms; and mean systolic LV peak pressure was 114 + or - 21, 97 + or - 18, 103 + or - 17 and 110 + or - 15 mmHg, respectively. LV activation was influenced by a slow conduction area at the pacing site and by the duration of transeptal time. CONCLUSION: An NCM during CRT is safe and feasible. It provides an additional information on electrical activation in SR and in various modality of pacing. Further studies with larger populations are needed in order to correlate electrical to clinical outcomes.
Claudio Pratola; Pasquale Notarstefano; Tiziano Toselli; Paolo Artale; Paolo Squasi; Elisa Baldo; Roberto Ferrari
Publication Detail:
Type:  Journal Article     Date:  2009-10-10
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-05-06     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  74-84     Citation Subset:  IM    
Cardiovascular Institute, Arcispedale S. Anna Hospital, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.
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MeSH Terms
Aged, 80 and over
Bundle-Branch Block / etiology
Cardiac Pacing, Artificial*
Electrophysiologic Techniques, Cardiac* / methods
Middle Aged
Ventricular Function, Left / physiology*

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