Non-contact left ventricular endocardial mapping in cardiac resynchronisation therapy

摘要: Background: Up to 30% of patients with heart failure do not respond cardiac resynchronisation therapy (CRT). This may reflect placement the coronary sinus lead in regions slow conduction despite optimal positioning on current criteria. Objectives: To characterise effect CRT left ventricular activation using non-contact mapping and examine electrophysiological factors influencing placement. Methods results: 10 implanted biventricular pacemakers were studied. In six, was found be positioned a region an average velocity 0.4 m/s, v 1.8 m/s normal (p < 0.02). Biventricular pacing ventricle paced 32 ms before right induced mean time integral timing for fusion depolarisation wavefronts from sites. Pacing outside decreased increased output dP/dtmax significantly. Conclusions: undergoing failure, can identify conduction. Significant haemodynamic improvements occur when site is these areas. Failure produce clinical benefits which overcome by more normally activating regions.