None listed
Conditions
Brief summary
Approximately 30%-40% patients do not respond to biventricular (BiV) pacing for cardiac resynchronisation therapy (CRT). Response to left bundle branch area pacing (LBBAP) also appears to be variable and ranges from no response to super-response. Whether differences in LV activation is responsible for this variable response is unclear. In this study, we aim to evaluate differences ventricular activation in patients with super-response and non-response to LBBAP and BiV-CRT.
Interventions
Heart failure patients who received biventricular pacing or left bundle pacing cardiac resynchronization therapy >1 year before will be included in the study. Only super-responders and non-responders who provide their informed consent will be included in the study. Non-invasive epicardial mapping of cardiac activation pattern will be done for all patients with Medtronic’s Cardioinsight technology.
Observational assessment will be completed in 30-60 min time period in clinic set up.
Observation
Heart failure patients who received biventricular pacing or left bundle pacing cardiac resynchronization therapy >1 year before will be included in the study. Only super-responders and non-responders who provide their informed consent will be included in the study. Non-invasive epicardial mapping of cardiac activation pattern will be done for all patients with Medtronic’s Cardioinsight technology. Observational assessment will be completed in 30-60 min time period in clinic set up. Observation will only be done once and the measurements will then be compared. If deemed necessary, endocardial mapping of biventricular activation will be done in cardiac electrophysiology laboratory. Octaray mapping catheter will be used for endocardial mapping.
Sponsors
Dr. Rajeev Kumar Pathak
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients with LBBB, QRS 130 ms or greater and HF who had LVEF 35% or less at baseline. 2. Received either BiV or LBBAP CRT. 3. Super-responders: Those who demonstrated 20% or more improvement in LVEF at 12 months post-procedure. 4. Non-responders: Those who demonstrated less than 10% in LVEF at 12 months post-procedure.
Exclusion criteria
1. Patients with dyssynchrony other than LBBB and/or QRS <130 ms at baseline 2. Patients with LVEF >35% at baseline 3. Patients with intermediate (10-19%) improvement in LVEF at 12 months post-procedure. 4. Refuse to/unable to give consent.
Outcome results
None listed