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Endocardial Left Ventricular Pacing Improves Cardiac Resynchronization Therapy in Chronic Asynchronous Infarction and Heart Failure ModelsClinical Perspective by Marc Strik, Leonard M. Rademakers, Caroline J.M. van Deursen, Arne van Hunnik, Marion Kuiper, Catherine Klersy, Angelo Auricchio, and Frits W. Prinzen Circ Arrhythm Electrophysiol Volume 5(1):191-200 February 14, 2012 Copyright © American Heart Association, Inc. All rights reserved. Schematic setup of the experiment (left panel) with mapping electrodes depicted as yellow dots. Marc Strik et al. Circ Arrhythm Electrophysiol. 2012;5:191200 Copyright © American Heart Association, Inc. All rights reserved. Typical examples of 3D electric activation in the LBBB, LBBB+MI, and LBBB+HF groups during baseline LBBB (left panels), CRT with EPI LV pacing (middle panels), and ENDO LV pacing (right panels). Marc Strik et al. Circ Arrhythm Electrophysiol. 2012;5:191200 Copyright © American Heart Association, Inc. All rights reserved. Overview of mean QRS duration, epicardial LV AT (activation time), and endocardial LV AT during EPI versus ENDO-CRT in dogs with LBBB, LBBB+MI, and LBBB+HF. Marc Strik et al. Circ Arrhythm Electrophysiol. 2012;5:191200 Copyright © American Heart Association, Inc. All rights reserved. Typical examples of short-axis electric activation during baseline LBBB (left), EPI-CRT (top right), and ENDO-CRT (bottom right), obtained by electrode band and multielectrode array mapping. Marc Strik et al. Circ Arrhythm Electrophysiol. 2012;5:191200 Copyright © American Heart Association, Inc. All rights reserved. Percentage change in LV dP/dtmax (top panel) and during LV total activation duration (bottom panel) during EPI versus ENDO-CRT in dogs with LBBB, LBBB+MI, and LBBB+HF. *P<0.05 compared with baseline atrial pacing. #P<0.05 compared with EPI-CRT. Marc Strik et al. Circ Arrhythm Electrophysiol. 2012;5:191200 Copyright © American Heart Association, Inc. All rights reserved. A, Mean±SD of conduction velocities (in m/s) of the epicardium and endocardium in anterior, lateral, and posterior regions in dogs with acute LBBB and chronic LBBB+HF. #P<0.05 for epicardial versus endocardial. Marc Strik et al. Circ Arrhythm Electrophysiol. 2012;5:191200 Copyright © American Heart Association, Inc. All rights reserved. Increase in LV dP/dtmax (mean values and SD, pooled by regions, compared with baseline) during ENDO-CRT as a function of the percentage increase in LV dP/dtmax during EPI-CRT in dogs with LBBB, LBBB+MI, and LBBB+HF. Marc Strik et al. Circ Arrhythm Electrophysiol. 2012;5:191200 Copyright © American Heart Association, Inc. All rights reserved. Spatial distribution of pacing sites (indicated by gray circles) that provide a certain percentage increase in LV electric resynchronization and LV dP/dtmax during EPI-CRT and ENDO-CRT compared with baseline atrial pacing. Marc Strik et al. Circ Arrhythm Electrophysiol. 2012;5:191200 Copyright © American Heart Association, Inc. All rights reserved.
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