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Feasibility of cathodic‐anodal left ventricular stimulation for alternative multisite pacing
Author(s) -
Dell'Era Gabriele,
Vecchi Federica,
Prenna Eleonora,
Devecchi Chiara,
Degiovanni Anna,
Malacrida Maurizio,
Magnani Andrea,
Occhetta Eraldo,
Marino Paolo
Publication year - 2018
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13344
Subject(s) - medicine , qrs complex , cardiology , cathodic protection , stimulation , cardiac resynchronization therapy , anesthesia , heart failure , electrode , ejection fraction , electrochemistry , chemistry
Background Simultaneous cathodic‐anodal capture by a bipole of a cardiac resynchronization therapy (CRT) left‐ventricular (LV) catheter may depolarize a larger LV area than conventional multipoint pacing. We evaluated the feasibility of cathodic‐anodal LV stimulation. Methods In 30 patients undergoing CRT with a quadripolar LV lead, we evaluated the cathodic and anodal capture threshold for each LV pole and compared QRS on electrocardiogram (ECG) during single‐point cathodic biventricular stimulation (S‐BS), multipoint BS (M‐BS), and cathodic‐anodal BS (CA‐BS). Results Anodal capture was obtained by three poles in 23/30 patients, by two poles in five, and was not feasible in two. The mean single‐point anodal threshold was 3.93 V versus single‐point cathodic threshold of 1.95 V. On comparing ECGs, M‐BS and CA‐BS produced similar QRS wavefront activation in 90% of patients. Conclusions CA‐BS is feasible and may be used in LV pacing to achieve a different wavefront of electrical activation. Further prospective studies are needed in order to verify the clinical impact of this kind of stimulation.