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PROLONGED ELECTRICAL LATENCY DURING LV PACING: EXTENT
AND MAGNITUDE IN THE CRT POPULATION
Salvatore Ivan Caico - A. O. Sant'Antonio Abate, Gallarate (VA); Antonio D'Onofrio - Ospedale
Monaldi, Napoli; Valter Bianchi - Ospedale Monaldi, Napoli; Luigi Padeletti - Ospedale Careggi,
Università di Firenze, Firenze; Michele Accogli - Ospedale G. Panico, Tricase (LE); Patrizia Pepi Ospedale Carlo Poma, Mantova; Antonio De Simone - Clinica San Michele, Maddaloni (CE); Pietro
Palmisano - Ospedale G. Panico, Tricase (LE); Alfredo Spotti - Istituti Ospitalieri, Cremona; Maurizio
Del Greco - Ospedale Santa Maria del Carmine, Rovereto (TN); Daniela Orsida - A. O. Sant'Antonio
Abate, Gallarate (VA); Maurizio Malacrida - Boston Scientific Italia, Milano; Giuseppe Stabile Clinica Mediterranea, Napoli
Purpose: Purpose of the study was to investigate the occurrence of prolonged electrical latency (PEL)
during left ventricular pacing (LVP) in an unselected population of CRT patients.
Methods: We collected data of 523 consecutive patients with a valid 12-lead ECG who underwent CRT
implantation in 35 Italian centers. Pacemaker stimulus-to-QRS onset intervals (SQOI) were measured
during LVP at the programmed output settings. The occurrence of PEL was confirmed in presence of a
SQOI>=40ms.
Results: During LVP the proportion of patients showing PEL in more than one ECG lead was 12%, in
addition to 9% of patients with an isoelectric onset of the QRS complex in only one lead. The presence
of PEL was not related to the LV lead position. Nonetheless, the prevalence of PEL was significantly
higher in the ischemic patients (15% vs. 10%, p=0.045).
Conclusions: A wide mismatch between RV and LV activation times during biventricular pacing could
impair CRT effectiveness and could require the anticipation of LV stimulation via a programmable V-V
delay. Our preliminary findings show that the PEL in LV activation occurs frequently during LVP.