In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to EHRA Ivory (& above) Members, Fellows of the ESC and Young combined Members

Left ventricular septal pacing as a single ventricular lead approach to cardiac resynchronization therapy: acute hemodynamic and electrophysiological effects

Session Rapid Fire 5: improving the response to cardiac resynchronization therapy: emerging technologies

Speaker Fcwm Salden

Congress : EHRA 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Cardiac Resynchronization Therapy
  • Session type : Rapid Fire Abstracts
  • FP Number : 924

Authors : FCWM Salden (Maastricht,NL), JG Luermans (Maastricht,NL), R Cornelussen (Maastricht,NL), S Ghosh (Mounds View, MN,US), FW Prinzen (Maastricht,NL), K Vernooy (Maastricht,NL)


FCWM Salden1 , JG Luermans2 , R Cornelussen3 , S Ghosh4 , FW Prinzen1 , K Vernooy2 , 1Cardiovascular Research Institute Maastricht (CARIM), Physiology - Maastricht - Netherlands , 2Maastricht University Medical Centre (MUMC), Cardiology - Maastricht - Netherlands , 3Medtronic, Bakken Research Center - Maastricht - Netherlands , 4Medtronic, CRHF - Mounds View, MN - United States of America ,


Cardiac resynchronization therapy (CRT) usually employs a right (RV) and left ventricular (LV) lead, but proper positioning and fixation of the latter in the coronary sinus may be problematic. In a previous patient study, permanent placement of a LV septal pacing lead by transvenous approach through the interventricular septum proved to be feasible.

To investigate non-inferiority of LV septal pacing as compared to conventional biventricular (BiV) pacing with respect to acute hemodynamic and electrophysiological effects in heart failure patients with an indication for CRT.

In this study, 15 patients undergoing a standard CRT implantation according to current guidelines underwent temporary pacing at various endocardial locations (LV septal pacing being achieved by transarterial approach). Acute hemodynamic response was assessed by LVdP/dtmax, relative to baseline AAI pacing. Electrical dyssynchrony was evaluated using the standard deviation of activation times (SDAT), computed from body surface isochronal maps based on 53-electrode body surface mapping.

LV septal pacing resulted in a significant LV dP/dtmax increase (19.2% ± 11.1%), that was at least as large as the LV dP/dtmax increase during conventional BiV pacing (17.7% ± 7.6%) and significantly larger than that induced by RV septal pacing (figure, left panel). Combined RV and LV septal pacing did not provide an additional increase in LV dP/dtmax. The electrophysiological response of the various pacing sites was comparable to the hemodynamic response (figure, right panel). LV septal pacing resulted in the largest reduction in SDAT, indicating significant electrical resynchronization.

LV septal pacing results in both acute hemodynamic improvement and electrical resynchronization that is at least as large as conventional BiV pacing. These results suggest that LV septal pacing with a single ventricular lead may serve as an alternative for conventional BiV pacing to obtain cardiac resynchronization.

The free consultation period for this content is over.

It is now only available year-round to EHRA Ivory (& above) Members, Fellows of the ESC and Young combined Members

Based on your interests

Three reasons why you should become a member

Become a member now
  • 1Access your congress resources all year-round on the New ESC 365
  • 2Get a discount on your next congress registration
  • 3Continue your professional development with free access to educational tools
Become a member now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim, Bristol-Myers Squibb and Pfizer Alliance, and Novartis Pharma AG. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are