BibTex format
@article{Samways:2026:10.1111/pace.70393,
author = {Samways, JW and Ali, N and Arnold, AD and Chow, J-J and Shun-Shin, M and Mohal, JS and Naraen, A and Saleh, K and Kaza, N and Sharma, C and Leinveber, P and Jurák, P and Keene, D and Liang, Y and Peters, NS and Kanagaratnam, P and Howard, JP and Qureshi, N and Ng, FS and Linton, NW and Lefroy, DC and Francis, DP and Lim, PB and Tanner, MA and Muthumala, A and Prinzen, FW and Lubrecht, JM and urila, K and Cole, G and Whinnett, Z},
doi = {10.1111/pace.70393},
journal = {Pacing Clin Electrophysiol},
title = {Non-Invasive Methods for Identifying Electrical Responders to Conduction System Pacing Cardiac Resynchronization Therapy.},
url = {http://dx.doi.org/10.1111/pace.70393},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BACKGROUND: Conduction system pacing (CSP) is an emerging alternative modality of cardiac resynchronization therapy (CRT). However, not all patients obtain electrical resynchronization with CSP, there is a clinical need for reliable non-invasive predictors of response. We aimed to assess the ability of several non-invasive modalities to predict electrical resynchronization with CSP-CRT. METHODS: Patients with standard heart failure CRT indications (excluding right-bundle branch block) underwent CSP-CRT using His-bundle and left-bundle branch pacing. Electrical resynchronization was defined as a >10 ms reduction in left ventricular activation time or conversion to a physiological left ventricular activation pattern on non-invasive multi-electrode mapping. We assessed whether 12-lead ECG morphology, vector electrocardiogram (VCG) derived QRS area, Ultra High Frequency (UHF)-ECG parameters or MRI scar burden predicted electrical resynchronization. RESULTS: Thirty four patients were analyzed (mean age 69±10 years; 82% male; LVEF 30±6%; QRS duration 161±23 ms; 32% ischemic cardiomyopathy). Electrical resynchronization was achieved in 24/34 (71%; 95%CI 53-85). Strauss criteria positivity on 12-lead ECG yielded a positive predictive value (PPV) of 83% (95%CI 61-95%) and negative predictive value (NPV) of 55% (95%CI 23-83%). VCG QRS area >100µVs demonstrated PPV 100% (95% CI 81-100%) and NPV 73% (95%CI 85-100%). UHF-ECG e-DYS >50 ms gave PPV 93% (95%CI 66-100%) and NPV 47% (23%-72%); >60 ms gave PPV 90% (95%CI 66-100%) and NPV 38% (95%CI 18-62%). MRI scar burden <15% resulted in PPV 88% (95%CI 64-99%) and NPV 56% (95%CI 21-86%). Lines of propagation discontinuity on multi-electrode mapping showed PPV 100% (95%CI 85-100%) and NPV 83% (95%CI 52-98%). CONCLUSIONS: Multiple non-invasive markers, including QRS morphology, VCG QRS area, UHF-ECG e-DYS, MRI scar burden showed potential to identify patients who are likely
AU - Samways,JW
AU - Ali,N
AU - Arnold,AD
AU - Chow,J-J
AU - Shun-Shin,M
AU - Mohal,JS
AU - Naraen,A
AU - Saleh,K
AU - Kaza,N
AU - Sharma,C
AU - Leinveber,P
AU - Jurák,P
AU - Keene,D
AU - Liang,Y
AU - Peters,NS
AU - Kanagaratnam,P
AU - Howard,JP
AU - Qureshi,N
AU - Ng,FS
AU - Linton,NW
AU - Lefroy,DC
AU - Francis,DP
AU - Lim,PB
AU - Tanner,MA
AU - Muthumala,A
AU - Prinzen,FW
AU - Lubrecht,JM
AU - urila,K
AU - Cole,G
AU - Whinnett,Z
DO - 10.1111/pace.70393
PY - 2026///
TI - Non-Invasive Methods for Identifying Electrical Responders to Conduction System Pacing Cardiac Resynchronization Therapy.
T2 - Pacing Clin Electrophysiol
UR - http://dx.doi.org/10.1111/pace.70393
UR - https://www.ncbi.nlm.nih.gov/pubmed/42606538
ER -