B-AB09-04 INTRA-PROCEDURAL ASSESSMENT OF IDEAL CARDIAC RESYNCHRONIZATION THERAPY STRATEGY USING LV LATERAL WALL ACTIVATION

Cardiac resynchronization therapy (CRT) can be achieved using biventricular (BiV) pacing, His Bundle Pacing (HBP), or left bundle branch pacing (LBBP). There are no good tools to intra-procedurally assess the best strategy for CRT. To use intra-procedural LV lateral wall activation (Q-LV) as a surrogate decide We included consecutive patients with Heart failure and LBBB CRT implantation based on current guidelines. A coated Vision wire was placed in of CS, which used baseline Q-LV BiV pacing. HBP then attempted overcome LBBB. If this failed narrow QRS duration (QRSd) decrease significantly, LBBP attempted. Q-LV, performed final (Figure). total 9 (age 62 ± 8 years, 78% women) underwent above strategy. Most had non-ischemic cardiomyopathy (78%) an average LVEF 20 7% QRSd 164 22ms. The mean 124 28 ms at baseline. HBP-CRT 3 (33%), LBBP-CRT 5 (55%) patients, CS-CRT 1 (11%) patient. significantly shortened 84 19 (p < 0.001). Final paced reduced from 22 119 32ms (p= 7 follow up echocardiographic data significant improvement 18 % 34 14% = 0.025). Intra-procedural measurement vision CS may act marker