inter-lead distance and inter-ventricular electrical delay for the

INTER-LEAD DISTANCE AND INTER-VENTRICULAR ELECTRICAL
DELAY FOR THE PREDICTION OF CRT RESPONSE
Albino Reggiani - Ospedale Carlo Poma, Mantova; Antonio D'Onofrio - Ospedale Monaldi, Napoli;
Antonio De Simone - Clinica San Michele, Maddaloni (CE); Luigi Padeletti - Ospedale Careggi,
Università di Firenze, Firenze; Antonio Rapacciuolo - Departments of Advanced Biomedical Sciences,
Federico II University of Naples, Napoli; Loredana Messano - Fondazione di Ricerca e Cura 'Giovanni
Paolo II', Università Cattolica del Sacro Cuore, Campobasso; Domenico Pecora - Ospedale
Poliambulanza, Brescia Michele Accogli - Ospedale G. Panico, Tricase (LE); Daniela Orsida Ospedale Sant'Antonio Abate, Gallarate (VA); Emanuele Bertaglia - Università di Padova; Giovanni
Luca Botto - Sant'Anna Hospital, San Fermo della Battaglia (CO); Maurizio Malacrida - Boston
Scientific Italia, Milano; Giuseppe Stabile - Clinica Mediterranea, Napoli
Purpose: The aim of our study was to verify the association between spontaneous electrical inter-lead
distance (EID) and direct (DCID) and the horizontal (HCID) corrected RV–LV electrode tip separation
in LBBB patients undergoing CRT.
Methods: 240 consecutive patients were enrolled. At the end of the implantation procedure, both EID,
defined as the time interval between spontaneous peak R-waves detected at the RV and LV pacing sites,
and DCID/HCID were recorded.
Results: Baseline data were: EID=76±37ms, cardio-thoracic-ratio=0.54±0.09, DCID=155±53mm and
HCID=126±67mm. Considering EID>80ms and HCID>127mm, defined by previous studies as the
values that best predict a positive response to CRT, we found a low association between the two
parameters at a K-test for concordance (k=0.320). On using a linear regression through the method of
least squares, no correlation was found between EID and CIDs (r=0.25).
Conclusion: Our results showed that these two variables are not fully interchangeable, and maximizing
CID on implantation will not ensure optimal EID and vice-versa. The LV pacing site that potentially
yields the best resynchronization is specific to each patient and is not predicted by anatomical position.

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