Heart Failure -> Cardiac Resynchronization Therapy: -> Lead and delivery systems D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-069 - Novel 12-lead Electrocardiographic Imaging Of Left Septal And His Bundle Pacing Strategies (ID 418)

 T. Bauch: Nothing relevant to disclose.


Background: Comparison of traditional and novel pacing has been used 12 lead ECG, echo, hemodynamics, and Electrographic imaging (ECGI). Current ECGI uses a 252-electrode vest. VIVO (Catheter Precision, Mt Olive NJ) is an investigational system that merges a standard 12 lead ECGs with a three-dimensional(3D) photo of the patient’s torso, and chest CT scan, to provide ECGI.
Objective: Assess the feasibility of 12-lead based ECGI using VIVO for comparing the ventricular activation patterns in patients with permanent left septal (LSP) or His bundle pacing (HBP).
Methods: Adults with chronic LSP or HBP and prior chest CT were recruited. ECGs were acquired during pacing and native conduction and imported into VIVO with a 3D torso photo and CT to generate ventricular models with superimposed isochrones. The timing and spread of activation were visually compared between native and paced beats, and the displayed origin compared with known stimulus locations determined during lead implantation.
Results: 14 subjects were processed, age 72 +-11, 66% male, with left septal pacing in 5. The figure shows the ventricular activation in two subjects. Panel A: Subject 1 native left bundle branch block, Panel B: LSP. Isochrones show improved LV-RV synchrony in panel B. Panel C: Subject 2 native conduction, Panel D: Non-selective HBP. LV-RV synchrony is minimally changed between native and HBP. Activation generally correlated well with expected patterns in 75% of subjects to date.
Conclusion: ECGI using 12 lead ECG data appears feasible in His bundle and left septal pacing. Further study is needed