{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:37:01Z","timestamp":1783579021494,"version":"3.55.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2014,10,15]],"date-time":"2014-10-15T00:00:00Z","timestamp":1413331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Current targeted left ventricular (LV) lead placement strategy is directed at the latest activated region during intrinsic activation. However, cardiac resynchronization therapy (CRT) is most commonly applied by simultaneous LV and right ventricular (RV) pacing without contribution from intrinsic conduction. Therefore, targeting the LV lead to the latest activated region during RV pacing might be more appropriate. We investigated the difference in LV electrical activation sequence between left bundle-branch block (LBBB) and RV apex (RVA) pacing using coronary venous electro-anatomic mapping (EAM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Twenty consecutive CRT candidates with LBBB underwent intra-procedural coronary venous EAM during intrinsic activation and RVA pacing using EnSite NavX. Left ventricular lead placement was aimed at the latest activated region during LBBB according to current recommendations. In all patients, LBBB was associated with a circumferential LV activation pattern, whereas RVA pacing resulted in activation from the apex of the heart to the base. In 10 of 20 patients, RVA pacing shifted the latest activated region relative to LBBB. In 18 of 20 patients, the LV lead was successfully positioned in the latest activated region during LBBB. For the whole study population, LV lead electrical delay, expressed as percentage of QRS duration, was significantly shorter during RVA pacing than during LBBB (72 \u00b1 13 vs. 82 \u00b1 5%, P = 0.035).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Right ventricular apex pacing alters LV electrical activation pattern in CRT patients with LBBB, and shifts the latest activated region in a significant proportion of these patients. These findings warrant reconsideration of the current practice of LV lead targeting for CRT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.178","type":"journal-article","created":{"date-parts":[[2014,10,15]],"date-time":"2014-10-15T05:49:19Z","timestamp":1413352159000},"page":"1214-1222","source":"Crossref","is-referenced-by-count":41,"title":["Different Regions of Latest Electrical Activation During Left Bundle-Branch Block and Right Ventricular Pacing in Cardiac Resynchronization Therapy Patients Determined by Coronary Venous Electro-Anatomic Mapping"],"prefix":"10.1093","volume":"16","author":[{"given":"Masih","family":"Mafi Rad","sequence":"first","affiliation":[{"name":"Maastricht University Medical Centre, Department of Cardiology , PO Box 5800, 6202 AZ, Maastricht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Blaauw","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre, Department of Cardiology , PO Box 5800, 6202 AZ, Maastricht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trang","family":"Dinh","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre, Department of Cardiology , PO Box 5800, 6202 AZ, Maastricht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Pison","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre, Department of Cardiology , PO Box 5800, 6202 AZ, Maastricht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry J.","family":"Crijns","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre, Department of Cardiology , PO Box 5800, 6202 AZ, Maastricht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frits W.","family":"Prinzen","sequence":"additional","affiliation":[{"name":"Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology , PO Box 616, 6200 MD, Maastricht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Vernooy","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre, Department of Cardiology , PO Box 5800, 6202 AZ, Maastricht ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,10,15]]},"reference":[{"key":"2026011921130642700_ejhf178-bib-0001","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1056\/NEJMoa050496","article-title":"The effect of cardiac resynchronization on morbidity and mortality in heart failure","volume":"352","author":"Cleland","year":"2005","journal-title":"N Engl J 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