26Īlthough our study lacked a control group of MPP programming without fusion, the final QRSd values in our analysis were substantially lower than those reported in the IRON-MPP trial, even despite that the majority of programming in that study was tailored to the narrowest QRSd (115.31 vs. In our method, the potential deleterious effects of RV pacing are felt to be decreased as multiple wavefronts are initiated. The overall baseline QRSd of 153.31 ± 24.60 ms was decreased to 115.31 ± 16.31 ms after MFP programming (p 80%) pacing, when combined with native activation like in the AdaptResponse clinical trial, seemed more beneficial than traditional CRT which includes RV pacing. A total of 22 patients (19 men and three women) with similar baseline characteristics were compared (all values in mean ± standard deviation). QRSd was compared between before and after programming. EGM-based measurements to determine the QRS septal onset to right ventricular (RV) time (SRAT) and the left ventricular (LV) to RV pacing conduction time were collected and applied to a formula to facilitate MFP. Patients in sinus rhythm with an AV conduction time of less than 350 ms were included in this analysis and were further stratified by strictly defined left bundle branch block (sLBBB) or nonspecific intraventricular conduction delay (IVCD). We therefore developed and tested a method combining MPP-CRT and controlled septal contribution to create a multifuse pacing (MFP) technique, establishing four ventricular activation sites for CRT patients using measurements from intracardiac electrograms (EGMs) and incorporating an AV-delay shortening algorithm (SyncAV™ Abbott Laboratories, Chicago, IL, USA) to narrow the QRSd. An additional site of activation via intrinsic conduction of the septum may further contribute to CRT however, the incorporation of all strategies together has yet to be explored. Multipoint pacing (MPP) has also demonstrated benefit in this population. Adaptive atrioventricular (AV)-shortening algorithms have achieved QRS duration (QRSd) narrowing in traditional cardiac resynchronization therapy (CRT) patients. RAFFAELE CORBISIERO, MD, FACC, 1 ANDREW MATHEW, DO, 1 CAITLIN BICKERT, BSN, 1 and DAVID MULLER, RN 2ġ Deborah Heart & Lung Center, Browns Mills, NJ, USAĪBSTRACT. Wide QRS complexes are seen throughout the EKG.Multipoint Pacing with Fusion-optimized Cardiac Resynchronization Therapy: Using It All to Narrow QRS Duration Shown below is an EKG with an RsR' pattern (M pattern) in leads III, aVL, aVF, and notching of the QRS complex in V5 depicting a left bundle branch block. These changes can be fixed and present at all heart rates, or they can be transient aberration either tachycardia or bradycardia dependent. and intraventricular conduction delays (IVCDs) affects the morphology or duration, or both, of the QRS complex. Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S OverviewĪ narrow QRS complex requires highly synchronous electrical activation of the ventricular myocardium through the rapidly conducting His-Purkinje system (HPS). Risk calculators and risk factors for Intraventricular conduction delay EKG examplesĮditor-In-Chief: C. To Hospitals Treating Intraventricular conduction delay EKG examples Intraventricular conduction delay EKG examples in the newsīlogs on Intraventricular conduction delay EKG examples Intraventricular conduction delay EKG examples On the WebįDA on Intraventricular conduction delay EKG examplesĬDC onIntraventricular conduction delay EKG examples Natural History, Complications and Prognosis Intraventricular conduction delay Microchaptersĭifferentiating Intraventricular conduction delay from other Disorders
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