Imperial College London
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DrAhranArnold

Faculty of Medicine, National Heart & Lung Institute

Clinical Senior Lecturer in Cardiology
 
 
 
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ahran.arnold

 
 
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Location

 

Fellows' RoomBlock B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Arnold:2021:10.1111/jce.14845,
author = {Arnold, AD and Shun-Shin, MJ and Keene, D and Howard, JP and Chow, J-J and Lim, E and Lampridou, S and Miyazawa, AA and Muthumala, A and Tanner, M and Qureshi, NA and Lefroy, DC and Koa-Wing, M and Linton, NWF and Boon, Lim P and Peters, NS and Kanagaratnam, P and Auricchio, A and Francis, DP and Whinnett, ZI},
doi = {10.1111/jce.14845},
journal = {Journal of Cardiovascular Electrophysiology},
pages = {428--438},
title = {Electrocardiographic predictors of successful resynchronization of left bundle branch block by his bundle pacing},
url = {http://dx.doi.org/10.1111/jce.14845},
volume = {32},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundHis bundle pacing (HBP) is an alternative to biventricular pacing (BVP) for delivering cardiac resynchronization therapy (CRT) in patients with heart failure and left bundle branch block (LBBB). It is not known whether ventricular activation times and patterns achieved by HBP are equivalent to intact conduction systems and not all patients with LBBB are resynchronized by HBP.ObjectiveTo compare activation times and patterns of His-CRT with BVP-CRT, LBBB and intact conduction systems.MethodsIn patients with LBBB, noninvasive epicardial mapping (ECG imaging) was performed during BVP and temporary HBP. Intrinsic activation was mapped in all subjects. Left ventricular activation times (LVAT) were measured and epicardial propagation mapping (EPM) was performed, to visualize epicardial wavefronts. Normal activation pattern and a normal LVAT range were determined from normal subjects.ResultsForty-five patients were included, 24 with LBBB and LV impairment, and 21 with normal 12-lead ECG and LV function. In 87.5% of patients with LBBB, His-CRT successfully shortened LVAT by ≥10 ms. In 33.3%, His-CRT resulted in complete ventricular resynchronization, with activation times and patterns indistinguishable from normal subjects. EPM identified propagation discontinuity artifacts in 83% of patients with LBBB. This was the best predictor of whether successful resynchronization was achieved by HBP (logarithmic odds ratio, 2.19; 95% confidence interval, 0.07–4.31; p = .04).ConclusionNoninvasive electrocardiographic mapping appears to identify patients whose LBBB can be resynchronized by HBP. In contrast to BVP, His-CRT may deliver the maximum potential ventricular resynchronization, returning activation times, and patterns to those seen in normal hearts.
AU  - Arnold,AD
AU  - Shun-Shin,MJ
AU  - Keene,D
AU  - Howard,JP
AU  - Chow,J-J
AU  - Lim,E
AU  - Lampridou,S
AU  - Miyazawa,AA
AU  - Muthumala,A
AU  - Tanner,M
AU  - Qureshi,NA
AU  - Lefroy,DC
AU  - Koa-Wing,M
AU  - Linton,NWF
AU  - Boon,Lim P
AU  - Peters,NS
AU  - Kanagaratnam,P
AU  - Auricchio,A
AU  - Francis,DP
AU  - Whinnett,ZI
DO  - 10.1111/jce.14845
EP  - 438
PY  - 2021///
SN  - 1045-3873
SP  - 428
TI  - Electrocardiographic predictors of successful resynchronization of left bundle branch block by his bundle pacing
T2  - Journal of Cardiovascular Electrophysiology
UR  - http://dx.doi.org/10.1111/jce.14845
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000604388900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://onlinelibrary.wiley.com/doi/10.1111/jce.14845
UR  - http://hdl.handle.net/10044/1/93080
VL  - 32
ER  -
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