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Incidence, predictors, and impact on outcome of increased left ventricular latency in patients undergoing cardiac resynchronization therapy

  • Antonio D’Onofrio
  • Salvatore Ivan Caico
  • Assunta Iuliano
  • Paolo Pieragnoli
  • Valter Bianchi
  • Daniela Orsida
  • Antonio Pani
  • Mario Pasqualini
  • Francesca Amadori
  • Ludovico Vasquez
  • Antonello Talarico
  • Chiara Minoia
  • Roberto Ospizio
  • Greta Merlotti
  • Maurizio Malacrida
  • Giuseppe Stabile
Article

Abstract

Purpose

Latency during left ventricle (LV) pacing has been suggested as a potential cause of ineffectual biventricular pacing. We assessed the incidence, predictors, and impact on outcome of increased LV latency in 274 patients undergoing cardiac resynchronization therapy (CRT).

Methods

On implantation, the latency interval was defined as the shortest stimulus-to-QRS onset interval in any lead of the 12-lead ECG. A stimulus-to-QRS onset interval ≥ 40 ms was used to define the presence of increased LV latency.

Results

Increased LV latency was observed in 55 patients (20%). On multivariate analysis, only ischemic etiology proved to be a predictor of increased LV latency. On 12-month echocardiographic evaluation, 68% patients showed a ≥ 15% decrease in LV end systolic volume (74% patients with increased LV latency, 67% patients without increased LV latency (p = 0.58). The presence of increased LV latency was not associated with a different clinical response to CRT.

Conclusions

Increased LV latency occurred in almost 20% of patients undergoing CRT and was more frequent in patients with ischemic heart disease. The presence of increased LV latency does not seem to have an impact on echocardiographic or clinical response to CRT.

Keywords

Cardiac resynchronization therapy Latency Ventricular pacing Ischemic heart disease with left ventricular pacing Outcome 

Notes

Compliance with ethical standards

The Institutional Review Board of each participating center approved the protocol, and each patient provided written informed consent before enrollment.

Conflict of interest

Roberto Ospizio, Greta Merlotti, and Maurizio Malacrida are employees of Boston Scientific, Inc. No other conflicts of interest exist.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Antonio D’Onofrio
    • 1
  • Salvatore Ivan Caico
    • 2
  • Assunta Iuliano
    • 3
  • Paolo Pieragnoli
    • 4
  • Valter Bianchi
    • 1
  • Daniela Orsida
    • 2
  • Antonio Pani
    • 5
  • Mario Pasqualini
    • 6
  • Francesca Amadori
    • 7
  • Ludovico Vasquez
    • 8
    • 9
  • Antonello Talarico
    • 10
  • Chiara Minoia
    • 2
  • Roberto Ospizio
    • 11
  • Greta Merlotti
    • 11
  • Maurizio Malacrida
    • 11
  • Giuseppe Stabile
    • 3
  1. 1.Unità Operativa di Elettrofisiologia, Studio e Terapia delle Aritmie, Monaldi, Ospedale MonaldiNaplesItaly
  2. 2.Ospedale Sant’Antonio AbateGallarateItaly
  3. 3.Clinica MediterraneaNaplesItaly
  4. 4.Azienda Ospedaliera CareggiFlorenceItaly
  5. 5.Ospedale ManzoniLeccoItaly
  6. 6.Ospedale Civile Destra SecchiaPieve di CorianoItaly
  7. 7.Ospedale San FrancescoNuoroItaly
  8. 8.Presidio Ospedaliero “G. Fogliani”MilazzoItaly
  9. 9.Azienda Sanitaria Provinciale di MessinaMessinaItaly
  10. 10.Ospedale AnnunziataCosenzaItaly
  11. 11.Boston Scientific ItaliaMilanoItaly

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