Pacing in proximity to scar during cardiac resynchronization therapy increases local dispersion of repolarization and susceptibility to ventricular arrhythmogenesis.

ABSTRACT:

Background

Cardiac resynchronization therapy (CRT) increases the risk of ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) when the left ventricular (LV) epicardial lead is implanted in proximity to scar.

Objective

The purpose of this study was to determine the mechanisms underpinning this risk by investigating the effects of pacing on local electrophysiology (EP) in relation to scar that provides a substrate for VT in ICM patients undergoing CRT.

Methods

Imaging data from ICM patients (n = 24) undergoing CRT were used to create patient-specific LV anatomic computational models including scar morphology. Simulations of LV epicardial pacing at 0.2-4.5 cm from the scar were performed using EP models of chronic infarct and heart failure (HF). Di

SUBMITTER: Mendonca Costa C 

PROVIDER: S-EPMC6774764 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature