Quest for the ideal assessment of electrical ventricular dyssynchrony in cardiac resynchronization therapy.

This paper reviews the literature on assessing electrical dyssynchrony for patient selection in cardiac resynchronization therapy (CRT). The guideline-recommended electrocardiographic (ECG) criteria for CRT are QRS duration and morphology, established through inclusion criteria in large CRT trials. However, both QRS duration and LBBB morphology have their shortcomings.

Automatically optimized vectorcardiographic features are associated with recurrence of atrial fibrillation after electrical cardioversion.

Electrical cardioversion presents one of the treatment options for atrial fibrillation (AF). However, the early recurrence rate is high, reaching ~40% three months after the procedure. Features based on vectorcardiographic signals were explored to find association with early recurrence of AF.

Accelerated atrial pacing reduces left-heart filling pressure: a combined clinical-computational study.

Background And Aims: Accelerated atrial pacing offers potential benefits for patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF), compared with standard lower-rate pacing. The study investigates the relationship between atrial pacing rate and left-heart filling pressure.

Methods: Seventy-five consecutive patients undergoing catheter ablation for AF underwent assessment of mean left atrial pressure (mLAP) and atrioventricular (AV) conduction delay (PR interval) in sinus rhythm and accelerated atrial pacing with 10 bpm increments up to Wenckebach block.

The mechanistic interaction between mechanical dyssynchrony and filling pressure in cardiac resynchronization therapy candidates.

Background: Both left ventricular (LV) mechanical dyssynchrony and filling pressure have been shown to be associated with outcome in heart failure patient treated with cardiac resynchronization therapy (CRT).

Objectives: To investigate the mechanistic link between mechanical dyssynchrony and filling pressure and to assess their combined prognostic value in CRT candidates.

Methods: Left atrial pressure (LAP) estimation and quantification of mechanical dyssynchrony were retrospectively performed in 219 CRT patients using echocardiography.

Assessment of ventricular electrical heterogeneity in left bundle branch pacing and left ventricular septal pacing by using various electrophysiological methods.

Introduction: Left bundle branch area pacing (LBBAP) comprises pacing at the left ventricular septum (LVSP) or left bundle branch (LBBP). The aim of the present study was to investigate the differences in ventricular electrical heterogeneity between LVSP, LBBP, right ventricular pacing (RVP) and intrinsic conduction with different dyssynchrony measures using the ECG, vectorcardiograpy, ECG belt, and Ultrahigh frequency (UHF-)ECG.

Methods: Thirty-seven patients with a pacemaker indication for bradycardia or cardiac resynchronization therapy underwent LBBAP implantation.