Optimizing lead placement for pacing in dyssynchronous heart failure: The patient in the lead

Philippe C. Wouters*, Kevin Vernooy, Maarten J. Cramer, Frits W. Prinzen, Mathias Meine

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Cardiac resynchronization therapy (CRT) greatly reduces morbidity and mortality in patients with dyssynchronous heart failure. However, despite tremendous efforts, response has been variable and can be further improved. Although optimizing left ventricular lead placement (LVLP) is arguably the cornerstone of CRT, the procedure of LVLP using the transvenous approach has remained largely unchanged for more than 2 decades. Improvements have been developed using scar location and electrical and/or mechanical mapping, and interest in conduction system pacing as an alternative to biventricular pacing has emerged recently. Conduction system pacing is promising but may not be suitable for all patients with dyssynchronous heart failure. This review underscores the importance of a patient-tailored approach and discusses the potential applications of both conduction system pacing and targeted biventricular CRT.

Original languageEnglish
Pages (from-to)1024-1032
Number of pages9
JournalHeart Rhythm
Volume18
Issue number6
DOIs
Publication statusPublished - Jun 2021

Keywords

  • Cardiac resynchronization therapy
  • Dyssynchrony
  • Heart failure
  • Lead placement
  • Left bundle branch block
  • CARDIAC RESYNCHRONIZATION THERAPY
  • LEFT-VENTRICULAR LEAD
  • BUNDLE-BRANCH BLOCK
  • ELECTRICAL DELAY
  • HIS-BUNDLE
  • ACTIVATION
  • CONDUCTION
  • ECHOCARDIOGRAPHY
  • OPTIMIZATION
  • STRATEGIES

Cite this