Cited by 379Cardiac pacing and defibrillation studiesCardiac Structural Anomalies and RepairCardiac Arrest and Resuscitation

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Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy

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Ypenburg, Claudia, van Bommel, Rutger J., Delgado, Victoria, Mollema, Sjoerd A., Bleeker, Gabe B., Boersma, Eric, Schalij, Martin J., Bax, Jeroen J.·2008·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2008.06.046

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Abstract

Objectives The aim of the current study was to evaluate echocardiographic parameters after 6 months of cardiac resynchronization therapy (CRT) as well as long-term outcome in patients with the left ventricular (LV) lead positioned at the site of latest activation (concordant LV lead position) as compared with that seen in patients with a discordant LV lead position.Background A nonoptimal LV pacing lead position may be a potential cause for nonresponse to CRT.Methods The site of latest mechanical activation was determined by speckle tracking radial strain analysis and related to the LV lead position on chest X-ray in 244 CRT candidates. Echocardiographic evaluation was performed after 6 months. Long-term follow-up included all-cause mortality and hospitalizations for heart failure.Results Significant LV reverse remodeling (reduction in LV end-systolic volume from 189 +/- 83 ml to 134 +/- 71 ml, p < 0.001) was noted in the group of patients with a concordant LV lead position (n = 153, 63%), whereas patients with a discordant lead position showed no significant improvements. In addition, during long-term follow-up (32 +/- 16 months), less events (combined for heart failure hospitalizations and death) were reported in patients with a concordant LV lead position. Moreover, a concordant LV lead position appeared to be an independent predictor of hospitalization-free survival after long-term CRT (hazard ratio: 0.22, p = 0.004).Conclusions Pacing at the site of latest mechanical activation, as determined by speckle tracking radial strain analysis, resulted in superior echocardiographic response after 6 months of CRT and better prognosis during long-term follow-up.

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Items 201–300 of 379

Absence of additional improvement in outcome of patients receiving cardiac resynchronization therapy paced at the most delayed left ventricular region
Deplagne, A., Lafitte, S., Reuter, S., Réant, P., Ploux, S., Mokrani, B., Roudaut, R. P., Jaı̈s, P., Haı̈ssaguerre, M., Clémenty, J., et al. (2009) · Archives of cardiovascular diseases · doi:10.1016/j.acvd.2009.05.005 · Cited by 8
Right ventricular lead adjustment in cardiac resynchronization therapy and acute hemodynamic response: a pilot study
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Effect of left ventricular pacing mode and site on hemodynamic, torsional and strain indices
Toumanidis, S. T., Kaladaridou, A., Bramos, D., Skaltsiotes, E., Agrios, J., Georgiopoulos, G., Antoniou, A., Pamboucas, K., Papadopoulou, E., & Moulopoulos, S. D. (2016) · Hellenic Journal of Cardiology · doi:10.1016/j.hjc.2016.04.005 · Cited by 7
“LV lead position at the lateral wall is recommended because this is the site of greatest contractile delay.(9,10) Conversely, LV apical pacing maintains a closer to normal electric activation pattern as well as mechanic synchrony and coordination.”
Background
Assessment of left ventricular dyssynchrony by three‐dimensional echocardiography: Prognostic value in patients undergoing cardiac resynchronization therapy
Höke, U., Bax, J. J., Delgado, V., & Marsan, N. A. (2018) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.13445 · Cited by 7
Self-citation
Left Ventricular Lead Position and Nonspecific Conduction Delay Are Predictors of Mortality in Patients During Cardiac Resynchronization Therapy
Prochnau, D., Kuehnert, H., Heinke, M., Figulla, H. R., & Surber, R. (2011) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2010.12.066 · Cited by 7
Left Ventricular Dyssynchrony Predicts Clinical Response to CRT – A Long‐Term Follow‐Up Single‐Center Prospective Observational Cohort Study
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Three-dimensional Imaging in Cardiac Resynchronization Therapy
Auger, D., Schalij, M. J., Bax, J. J., & Delgado, V. (2011) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2011.06.015 · Cited by 7
Self-citation
Mechanical dyssynchrony and deformation imaging in patients with functional mitral regurgitation
Rosa, I. (2016) · World Journal of Cardiology · doi:10.4330/wjc.v8.i2.146 · Cited by 7
Acute Modifications of Left Ventricular Torsional Mechanics Induced by Cardiac Resynchronization Therapy Affect Short-Term Reverse Remodeling
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The desire for physiological pacing: Are we there yet?
Kaye, G. (2019) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.14248 · Cited by 7
“However, a recent paper suggests that patients should also be assessed during exercise.64,65 A long‐term observational retrospective study in children showed that those paced from either the LV apex or free wall had better preservation of LV function over time, suggesting that LV lead position is also important.67 On…”
BackgroundInfluential
Utility of Speckle Tracking Echocardiography to Characterize Dysfunctional Myocardium in Patients with Ischemic Cardiomyopathy Referred for Cardiac Resynchronization Therapy
Kydd, A. C., Khan, F. Z., Gopalan, D., Ring, L. S., Rana, B. S., Virdee, M. S., & Dutka, D. P. (2013) · Echocardiography · doi:10.1111/echo.12458 · Cited by 7
Speckle Tracking Echocardiography for Cardiac Resynchronization Therapy: Has the Right Ultrasound Technique Finally Been Found?
Mele, D. (2010) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2009.12.025 · Cited by 7
In the field of cardiac resynchronization therapy is left ventricular pacing via the coronary sinus a mature technique
Alonso, C. (2009) · EP Europace · doi:10.1093/europace/eup061 · Cited by 7
“The midlateral wall is usually considered as the optimal LV pacing site but other authors suggest that optimal position may be different from one patient to the other.(12,13) Nevertheless, because of the technical difficulties we have described above, reaching the target site is not always feasible.”
Background
Echocardiography and cardiac resynchronization therapy
Marek, J. J., Gandalovičová, J., Kejřová, E., Psenicka, M., Linhart, A., & Paleček, T. (2015) · Cor et Vasa · doi:10.1016/j.crvasa.2015.08.001 · Cited by 6
A novel fluoroscopic method of measuring right-to-left interlead distance as a predictor of reverse left ventricular remodeling after cardiac resynchronization therapy
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“We thus reduced the potentially confounding effect of pacing sites generally considered less favorable [12, 13], although recent data have also shown satisfactory results with anterior and anterolateral LV lead locations [14].”
Result
A modified echocardiographic protocol with intrinsic plausibility control to determine intraventricular asynchrony based on TDI and TSI
Dreger, H., Borges, A. C., ISMER, B., Schattke, S., Stegemann, B., Baumann, G., & Melzer, C. (2009) · Cardiovascular Ultrasound · doi:10.1186/1476-7120-7-46 · Cited by 6
Postprocedure Mapping of Cardiac Resynchronization Lead Position Using Standard Fluoroscopy Systems: Implications for the Nonresponder with Scar
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Pacing site in pacemaker dependency: is right ventricular septal lead position the answer?
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Efficacy of a tool combining guide-wire and stylet for the left ventricular lead positioning
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Diverse patterns of longitudinal and radial dyssynchrony in patients with advanced systolic heart failure
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Self-citation
Hemodynamics of Cardiac Pacing: Optimization and Programming to Enhance Cardiac Function
Syed, F. F., Hayes, D. L., Friedman, P. A., & Asirvatham, S. J. (2012) · Wiley eBooks · doi:10.1002/9781118483923.ch2 · Cited by 5
Mechanical Dyssynchrony Is Not Everything of Substrate but Is Essential for Cardiac Resynchronization Therapy - Is Assessment of Mechanical Dyssynchrony Necessary in Determining CRT Indication? (Pro) -
Kanzaki, H. (2011) · Circulation Journal · doi:10.1253/circj.cj-10-1221 · Cited by 5
A Review of Image-guided Approaches for Cardiac Resynchronisation Therapy
Tang, H., Tang, S., & Zhou, W. (2017) · Arrhythmia & Electrophysiology Review · doi:10.15420/aer.2016.32.2 · Cited by 5
Correlation between LV Regional Strain and LV Dyssynchrony Assessed by 2D STE in Patients with Different Levels of Diastolic Dysfunction
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Approach to cardiac resyncronization therapy
Dobreanu, D., Dagres, N., Svendsen, J. H., Marinskis, G., Bongiorni, M. G., & Blomström‐Lundqvist, C. (2012) · EP Europace · doi:10.1093/europace/eus260 · Cited by 5
How to deliver optimal cardiac resynchronisation therapy
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Electrical delays in quadripolar leads with cardiac resynchronization therapy
Koerber, S. M., Field, M. E., Cobb, D. B., Gregoski, M. J., Sturdivant, J. L., & Gold, M. R. (2021) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.15156 · Cited by 5
“The best studied measure of electrical delay is the QLV interval, measured from the onset of the surface QRS complex to the local activation at the site of the LV lead.(13) Subsequently, it was shown that local interventricular conduction time (RV‐LV) also predicts CRT response and is at least as good as QLV.”
BackgroundMethod
Cardiac magnetic resonance imaging: Which information is useful for the arrhythmologist?
Maria, E. D., Aldrovandi, A., Borghi, A., Modonesi, L., & Cappelli, S. (2017) · World Journal of Cardiology · doi:10.4330/wjc.v9.i10.773 · Cited by 5
Predictors of nonsimultaneous interventricular delay at cardiac resynchronization therapy optimization
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Left ventricle automatic pacing threshold management in CRT systems: A comprehensive review
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Long‐term clinical response to cardiac resynchronisation therapy under a multidisciplinary model
O’Donnell, D., Lin, T., Swale, M., Rae, P., Flannery, D., & Srivastava, P. (2013) · Internal Medicine Journal · doi:10.1111/imj.12284 · Cited by 4
Rethinking cardiac resynchronization therapy: The impact of ventricular dyssynchrony on outcome
Prinz, C., Felice, C. D., Lehmann, R., Schwarz, M., Prinz, E., Bitter, T., Vogt, J., Lamp, B., Faber, L., & Horstkotte, D. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.06.060 · Cited by 4
“Recent trials demonstrated the influence of different lead positions on CRT response [44,45].”
Background
Relationship Between Changes in Pulse Pressure and Frequency Domain Components of Heart Rate Variability During Short-Term Left Ventricular Pacing in Patients with Cardiac Resynchronization Therapy
Urbanek, B., Ruta, J., Kudryński, K., Ptaszynski, P. A., Klimczak, A., & Wranicz, J. K. (2016) · Medical Science Monitor · doi:10.12659/msm.895489 · Cited by 4
Integrated Assessment of Left Ventricular Electrical Activation and Myocardial Strain Mapping in Heart Failure Patients
Maffessanti, F., Prinzen, F. W., Conte, G., Regoli, F. D., Caputo, M. L., Sürder, D., Moccetti, T., Faletra, F. F., Krause, R., & Auricchio, A. (2017) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2017.08.011 · Cited by 4
Clinical impacts of scar reduction on gated myocardial perfusion SPECT after cardiac resynchronization therapy
Wang, C.-Y., Hung, G., Lo, H., Tsai, S., He, Z., Zhang, X., Chiang, K.-F., Zou, J., Zhou, W., Huang, J., et al. (2021) · Journal of Nuclear Cardiology · doi:10.1007/s12350-021-02722-7 · Cited by 4
Effect of Cardiac Resynchronization Therapy on the Sequence of Mechanical Activation Assessed by Two-Dimensional Radial Strain Imaging
Auger, D., Höke, U., Thijssen, J., Abate, E., Yiu, K., Ewe, S. H., Witkowski, T. G., Leong, D. P., Holman, E. R., Marsan, N. A., et al. (2013) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2013.11.059 · Cited by 4
Self-citation
Interventricular delay measurement using equilibrium radionuclide angiography before resynchronization therapy should be performed outside the area of segmental wall motion abnormalities
Courtehoux, M., ZANNAD, N., Fauchier, L., Babuty, D., & Eder, V. (2010) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-010-1629-4 · Cited by 4
“Optimization of site pacing considering the location of the area of delayed contraction in ERNA could improve prognosis during long-term follow-up as shown with echocardiography [22, 23].”
Background
Echocardiography in Cardiac Resynchronization Therapy
Höke, U., Bax, J. J., Marsan, N. A., & Delgado, V. (2018) · Springer eBooks · doi:10.1007/978-3-319-71617-6_26 · Cited by 4
Self-citation
Implementation of seven echocardiographic parameters of myocardial asynchrony to improve the long-term response rate of cardiac resynchronization therapy (CRT)
Knebel, F., Schattke, S., Bondke, H., Richter, C., Melzer, C., Dreger, H., Grohmann, A., Baumann, G., & Borges, A. C. (2008) · Cardiovascular Ultrasound · doi:10.1186/1476-7120-6-58 · Cited by 4
Cardiac resynchronization therapy: relevance of right ventricular function evaluation
Delgado, V., & Bax, J. J. (2010) · EP Europace · doi:10.1093/europace/euq030 · Cited by 4
Self-citation
Test–re-test reproducibility of Doppler echocardiography for assessment of electromechanical dyssynchrony: Implications for heart failure clinic
Palmieri, V., Russo, C. A., Buonomo, A., Cimmino, G., Tartaglione, D., Pezzullo, S., & Celentano, A. (2010) · Journal of Cardiology · doi:10.1016/j.jjcc.2010.06.002 · Cited by 3
Optimizing Cardiac Resynchronization Therapy for Congestive Heart Failure
Duggirala, S., & Lee, B. K. (2013) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2013.03.003 · Cited by 3
Pacing within the Ischemic Area Significantly Decreases the Left Ventricular Ejection Fraction during Experimental Acute Myocardial Infarction
Toumanidis, S. T., Takos, D., Tsirikos, N., BRAMOS, D., Kottis, G., Antoniou, A., Skaltsiotis, E., Kaladaridou, A., & Moulopoulos, S. D. (2010) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2010.02904.x · Cited by 3
Getting the LV lead to the right spot
JACKSON, K. P., & Steen, T. (2015) · Netherlands Heart Journal · doi:10.1007/s12471-015-0774-6 · Cited by 3
Coronary sinus lead delay index for optimization of coronary sinus lead placement
Koç, M., Kaypaklı, O., Gözübüyük, G., & Şahin, D. Y. (2017) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12454 · Cited by 3
Coronary sinus and great cardiac vein electroanatomic mapping predicts the activation delay of the coronary sinus branches
Maines, M., Peruzza, F., Zorzi, A., Moggio, P., Angheben, C., Catanzariti, D., Coletti, M., Pangrazzi, C., & Greco, M. D. (2020) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.14609 · Cited by 3
Clinical outcome of cardiac resynchronization therapy in patients randomized to an active fixation bipolar left ventricular lead versus a passive quadripolar lead
Keilegavlen, H., Schuster, P. M., Hovstad, T., & Færestrand, S. (2021) · Scandinavian Cardiovascular Journal · doi:10.1080/14017431.2020.1869299 · Cited by 3
Cardiac resynchronization therapy outcomes with left ventricular lead concordant with latest mechanical activation: A meta‐analysis
LaPointe, N. M. A., Ali‐Ahmed, F., Dalgaard, F., Kosinski, A. S., Sanders, G. D., & Al‐Khatib, S. M. (2022) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.14549 · Cited by 3
Are changes in the extent of left ventricular dyssynchrony as assessed by speckle tracking associated with response to cardiac resynchronization therapy?
Ghani, A., Delnoy, P. P. H. M., Ottervanger, J. P., Misier, A. R. R., Smit, J. J. J., Adiyaman, A., & Elvan, A. (2015) · International journal of cardiac imaging · doi:10.1007/s10554-015-0809-5 · Cited by 3
Cardiac Resynchronization Therapy Programming and Troubleshooting
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Nuclear Image-Guided Methods for Cardiac Resynchronization Therapy
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Bifocal left ventricular stimulation or the optimal left ventricular stimulation site in cardiac resynchronization therapy: a pressure–volume loop study
de Roest, G. J., Wu, L., de Cock, C. C., Delnoy, P.-P. H. M., Hendriks, M. L., van Rossum, A. C., & Allaart, C. P. (2015) · EP Europace · doi:10.1093/europace/euv280 · Cited by 3
“An alternative approach is to position LV lead to a patient-specific optimal LV site based on highest pump function improvement or latest mechanical activation.(8,9) In a randomized clinical trial using this approach, Khan et al.”
MethodResult
Comparison of Echocardiographic Markers of Cardiac Dyssynchrony and Latest Left Ventricular Activation Site in Heart Failure Patients with and without Left Bundle Branch Block.
Lotfi‐Tokaldany, M., Savand-Roomi, Z., Kasemisaeid, A., & Sadeghian, H. (2013) · Europe PMC (PubMed Central) · Cited by 3
High Left Ventricular Lead Sensing Delay Predicts QRS Narrowing and Good Response to Cardiac Resynchronization Therapy
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Optimal image reconstruction using multidetector‐row computed tomography to facilitate cardiac resynchronization therapy
Izawa, Y., Mori, S., Nishii, T., Matsuzoe, H., Imada, H., Suehiro, H., Nakayama, K., Matsumoto, K., Tanaka, H., Fujiwara, S., et al. (2017) · Echocardiography · doi:10.1111/echo.13571 · Cited by 3
Comparison of three-dimensional echocardiography and speckle tracking echocardiography in quantification and mapping of intraventricular mechanical dyssynchrony
Bhambhani, A., & Mathew, A. (2019) · Indian Heart Journal · doi:10.1016/j.ihj.2019.04.006 · Cited by 3
Coronary venoplasty during cardiac resynchronization therapy device implantations: Acute results and clinical outcomes
Boey, E., Tan, E. S. J., Yeo, W. T., Singh, D., Lim, T. W., Kojodjojo, P., & Seow, S. (2019) · Heart Rhythm · doi:10.1016/j.hrthm.2019.12.012 · Cited by 3
LOCALIZATION OF THE LEFT VENTRICULAR MYOCARDIAL SCARRING AND ITS ELECTRICAL ACTIVATION IN PATIENTS WITH HEART FAILURE AND DIFFERENT RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY
Utsumueva, M. D., Миронова, Н. А., Стукалова, О. В., Михайловна, Г. Е., Kashtanova, S. Y., Malkina, T. A., Киктев, В. Г., & Sp, G. (2020) · Journal of Arrhythmology · doi:10.35336/va-2019-3-5-14 · Cited by 3
Should the Left Ventricular Pacing Lead Be Positioned at the Site of Latest Mechanical Activation in Cardiac Resynchronization Therapy?
van Bommel, R. J., Schalij, M. J., & Bax, J. J. (2008) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2008.01388.x · Cited by 3
Self-citation
Role of dyssynchrony in optimization of CRT implantation: a time to re-think?
Yu, C., & Fang, F. (2012) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jes141 · Cited by 3
Conduction system vs. biventricular pacing in heart failure with reduced ejection fraction: a meta-analysis of randomized controlled trials
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Implant Electrical Characteristics Predict Response to Cardiac Resynchronization Therapy
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Background
Acute Haemodynamic and Echocardiographic Effects of Multiple Configurations of Left Ventricular Pacing Sites in Acute Myocardial Infarction: Experimental Study
Matthaios, I., Kaladaridou, A., Skaltsiotes, E., Agrios, J., Antoniou, A., Georgiopoulos, G. A., Papadopoulou, E., Pamboucas, C., & Toumanidis, S. T. (2016) · Heart Lung and Circulation · doi:10.1016/j.hlc.2016.07.016 · Cited by 2
Short-Term Availability of Viable Left Ventricular Pacing Sites with Quartet™ Quadripolar Leads
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Initial Japanese experience and long-term follow-up with a new active fixation coronary sinus lead, the StarFix 4195
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Self-citation
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“(7) evaluated 244 patients undergoing CRT with a concordant LV lead position (where the LV pacing lead was positioned, according to chest radiograph, at the site of latest mechanical activation on 2-dimensional strain echocardiography) versus a discordant LV lead position (LV pacing lead outside the site of latest mec…”
MethodSelf-citation
Speckle Tracking Echocardiography Identifies Impaired Longitudinal Strain as a Common Deficit in Various Cardiac Diseases
Jeffrey, R., Hamburger, R. F., Gooden-Ebanks, J., & Petersen, J. W. (2018) · Cardiovascular Innovations and Applications · doi:10.15212/cvia.2017.0040 · Cited by 2
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“Hospitalization for HF n (%) 1 a,b (4) 4(16) 5(20) .”
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“Additionally, pre-procedure noninvasive imaging to identify site of delayed LV contraction to tailor lead position (19) might be helpful.”
Method
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Cardiac Resynchronization Therapy
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'Green light': watch it twice...
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Authors: Ypenburg, C., van Bommel, R. J., Delgado, V., Mollema, S. A., Bleeker, G. B., Boersma, E., Schalij, M. J., & Bax, J. J.
Affiliations: Leiden University Medical Center (NL)
Erasmus University Rotterdam (NL)
Corresponding author: Bax, Jeroen J.
ORCID: Delgado, Victoria
Boersma, Eric
Schalij, Martin J.
Bax, Jeroen J.
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2008-10
Volume: 52
Issue: 17
Pages: 1402-1409
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2008.06.046
OpenAlex: W2159040286
Cited by: 379
References: 38
Citations by year: 2026: 7 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 12 · 2020: 12 · 2019: 14 · 2018: 11 · 2017: 19 · 2016: 30 · 2015: 27 · 2014: 35 · 2013: 35 · 2012: 31
FWCI: 32.96
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 1749 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Funders: Boston Scientific Corporation
European Society of Cardiology
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Health Sciences › Medicine › Surgery › Cardiac Structural Anomalies and Repair
Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
Keywords: cardiac resynchronization therapy, left ventricular lead position, reverse remodeling, heart failure hospitalization, all-cause mortality, CRT response, echocardiographic response
MeSH terms: Aged, Cardiac Pacing, Artificial, Electrodes, Implanted, Female, Forecasting, Heart Failure, Heart Ventricles, Humans, Male, Middle Aged, Pacemaker, Artificial, Severity of Illness Index, Stroke Volume, Time Factors, Echocardiography, Doppler, Survival Analysis, Treatment Outcome, Ventricular Remodeling

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Optimal Left Ventricular Lead Position Predicts Reverse Remodeling and Survival After Cardiac Resynchronization Therapy

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