Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 4:10:1107415.
doi: 10.3389/fcvm.2023.1107415. eCollection 2023.

Left ventricular electrical potential measured by the NOGA XP electromechanical mapping method as a predictor of response to cardiac resynchronization therapy

Jacek Wilczek  1   2 , Tomasz Jadczyk  3   4 , Wojciech Wojakowski  3   5 , Krzysztof S Gołba  1   2
Affiliations

Left ventricular electrical potential measured by the NOGA XP electromechanical mapping method as a predictor of response to cardiac resynchronization therapy

Jacek Wilczek et al. Front Cardiovasc Med. .

Abstract

Objectives: The aim of the study was to determine whether left ventricular electrical potential measured by electromechanical mapping with the NOGA XP system has predictive value for response to CRT.

Background: Approximately 30% of patients who undergo cardiac resynchronization therapy do not see the expected effects.

Methods: The group of 38 patients qualified for CRT implantation were included in the study, of which 33 patients were analyzed. A 15% reduction in ESV after 6 months of pacing was used as a criterion for a positive response to CRT. The mean value and sum of unipolar and bipolar potentials obtained by mapping with the NOGA XP system and their predictive value in relation to the effect of CRT were analyzed using a bulls-eye projection at three levels: 1) the global value of the left ventricular (LV) potentials, 2) the potentials of the individual LV walls and 3) the mean value of the potentials of the individual segments (basal and middle) of the individual LV walls.

Results: 24 patients met the criterion of a positive response to CRT vs. 9 non-responders. At the global analysis stage, the independent predictors of favorable response to CRT were the sum of the unipolar potential and bipolar mean potential. In the analysis of individual left ventricular walls, the mean bipolar potential of the anterior and posterior wall and in the unipolar system, mean septal potential was found to be an independent predictor of favorable response to CRT. In the detailed segmental analysis, the independent predictors were the bipolar potential of the mid-posterior wall segment and the basal anterior wall segment.

Conclusions: Measurement of bipolar and unipolar electrical potentials with the NOGA XP system is a valuable method for predicting a favorable response to CRT.

Keywords: cardiac electrical potential; cardiac mapping; cardiac pacing; heart failure; resynchronization therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study group.
Figure 2
Figure 2
Bipolar (1) and unipolar (2) potential maps in patient KJ-5-non-responder (A) and patient RJ-31-responder (B).
Figure 3
Figure 3
Arrangement of individual walls in longitudinal section in bull-eye projection.
Figure 4
Figure 4
Arrangement of heart wall segments in cross-section in bull-eye projection.
See this image and copyright information in PMC

References

    1. Singh JP, Klein HU, Huang DT, Reek S, Kuniss M, Quesada A, et al. Left ventricular lead position and clinical outcome in the multicenter automatic defibrillator implantation trial–cardiac resynchronization therapy (MADIT-CRT) trial. Circulation. (2011) 123(11):1159–66. 10.1161/CIRCULATIONAHA.110.000646 - DOI - PubMed
    1. Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, et al. ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. ESC scientific document group. Europace. (2022) 24(1):71–164. 10.1093/europace/euab232 - DOI - PubMed
    1. Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP, et al. MADIT-CRT Trial investigators cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med. (2009) 361(14):1329–38. 10.1056/NEJMoa0906431 - DOI - PubMed
    1. Vinther M, Risum N, Svendsen JH, Møgelvang R, Philbert BT. A randomized trial of his pacing versus biventricular pacing in symptomatic HF patients with left bundle branch block (his-alternative). JACC Clin Electrophysiol. (2021) 7(11):1422–32. 10.1016/j.jacep.2021.04.003 - DOI - PubMed
    1. Kato H, Yanagisawa S, Sakurai T, Mizuno C, Ota R, Watanabe R, et al. Efficacy of his bundle pacing on LV relaxation and clinical improvement in HF and LBBB. JACC Clin Electrophysiol. (2022) 8(1):59–69. 10.1016/j.jacep.2021.06.011 - DOI - PubMed