Incidence, predictors, and impact on outcome of increased left ventricular latency in patients undergoing cardiac resynchronization therapy

J Interv Card Electrophysiol. 2018 Apr;51(3):245-252. doi: 10.1007/s10840-018-0321-7. Epub 2018 Mar 3.

Abstract

Purpose: Latency during left ventricle (LV) pacing has been suggested as a potential cause of ineffectual biventricular pacing. We assessed the incidence, predictors, and impact on outcome of increased LV latency in 274 patients undergoing cardiac resynchronization therapy (CRT).

Methods: On implantation, the latency interval was defined as the shortest stimulus-to-QRS onset interval in any lead of the 12-lead ECG. A stimulus-to-QRS onset interval ≥ 40 ms was used to define the presence of increased LV latency.

Results: Increased LV latency was observed in 55 patients (20%). On multivariate analysis, only ischemic etiology proved to be a predictor of increased LV latency. On 12-month echocardiographic evaluation, 68% patients showed a ≥ 15% decrease in LV end systolic volume (74% patients with increased LV latency, 67% patients without increased LV latency (p = 0.58). The presence of increased LV latency was not associated with a different clinical response to CRT.

Conclusions: Increased LV latency occurred in almost 20% of patients undergoing CRT and was more frequent in patients with ischemic heart disease. The presence of increased LV latency does not seem to have an impact on echocardiographic or clinical response to CRT.

Keywords: Cardiac resynchronization therapy; Ischemic heart disease with left ventricular pacing; Latency; Outcome; Ventricular pacing.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Analysis of Variance
  • Cardiac Pacing, Artificial / methods*
  • Cardiac Pacing, Artificial / mortality
  • Cardiac Resynchronization Therapy / methods
  • Cardiac Resynchronization Therapy / mortality
  • Cohort Studies
  • Echocardiography
  • Electrocardiography*
  • Female
  • Heart Failure / diagnostic imaging
  • Heart Failure / mortality
  • Heart Failure / therapy*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / mortality
  • Myocardial Ischemia / therapy*
  • Prognosis
  • Prospective Studies
  • Registries
  • Risk Assessment
  • Severity of Illness Index
  • Survival Rate
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / therapy