Non-invasive electrophysiological mapping of the patients undergoing cardiac resynchronization therapy: the role of left ventricular lead position

Objective. To study possibilities of non-invasive electrophysiological mapping (NEM) in assessment of dependence of cardiac resynchronization effect from the position of the left ventricular electrode (LVE). Design and methods. NEM was performed on 24 patients, utilizing the «Amycard 01C EP LAB». Position of the stimulation LVE pole was estimated on the segmental epicardial ventricular model; and the epicenter of the late activation area of the left ventricular (LV) with complete left bundle branch block (LBBB) was determined. Also the interventricular electrode distance was measured. Results. The epicenter of the late zone on LBBB most frequently was determined in the basal area on the border of the posterior and lateral walls of the LV - 42 % (n = 10). In patients with response to cardiac resynchronization therapy (CRT) the distance (LVE pole - the epicenter of the epicardial late activation area of the LV on LBBB) was not significantly greater than the width of the LV segment. The smallest interventricular electrode distance of 49 mm was found in patient without response to CRT. Conclusion. Using NEM, one may accurately measure the distance between the stimulating poles of ventricular electrodes and the distance from the stimulating LVE pole to the epicenter of the epicardial late activation area of the LV on LBBB. The CRT effect is clearer if the distance between LVE and late zone is not significantly greater than the width of one LV segment.

неинвазивное электрофизиологическое картирование, полная блокада левой ножки пучка Гиса, позиция левожелудочкового электрода, сердечная ресинхронизирующая терапия, non-invasive electrophysiological mapping, left bundle branch block, position LV lead, cardiac resynchronization therapy

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