{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:44:18Z","timestamp":1761561858073},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,5,12]],"date-time":"2014-05-12T00:00:00Z","timestamp":1399852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Optimization of Left Ventricular Lead Position<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The left ventricular (LV) lead local electrogram (EGM) delay from the beginning of the QRS complex (QLV) is considered a strong predictor of response to cardiac resynchronization therapy. We have developed a method for fast epicardial QLV mapping during video\u2010thoracoscopic surgery to guide LV lead placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A three\u2010port, video\u2010thoracoscopic approach was used for LV free wall epicardial mapping and lead implantation. A decapolar electrophysiological catheter was introduced through one port and systematically attached to multiple accessible LV sites. The pacing lead was targeted to the site with maximum QLV. The LV free wall activation pattern was analyzed in 16 pre\u2010specified anatomical segments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We implanted LV leads in 13 patients with LBBB or IVCD. The procedural and mapping times were 142 \u00b1 39 minutes and 20 \u00b1 9 minutes, respectively. A total of 15.0 \u00b1 2.2 LV segments were mappable with variable spatial distribution of QLV\u2010optimum. The QLV ratio (QLV\/QRSd) at the optimum segment was significantly higher (by 0.17 \u00b1 0.08, p &lt; 0.00001) as compared to an empirical midventricular lateral segment. The LV lead was implanted at the optimum segment in 11 patients (at an adjacent segment in 2 patients) achieving a QLV ratio of 0.82 \u00b1 0.09 (range 0.63\u20130.93) and 99.5 \u00b1 0.6% match with intraprocedural mapping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Video\u2010thoracoscopic LV lead implantation can be effectively and safely guided by epicardial QLV mapping. This strategy was highly successful in targeting the selected LV segment and resulted in significantly higher QLV ratios compared to an empirical midventricular lateral segment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.12430","type":"journal-article","created":{"date-parts":[[2014,4,11]],"date-time":"2014-04-11T18:20:47Z","timestamp":1397240447000},"page":"882-888","source":"Crossref","is-referenced-by-count":11,"title":["High\u2010Density Epicardial Activation Mapping to Optimize the Site for Video\u2010Thoracoscopic Left Ventricular Lead Implant"],"prefix":"10.1111","volume":"25","author":[{"given":"ROSTISLAV","family":"POLASEK","sequence":"first","affiliation":[{"name":"Department of Cardiology Regional Hospital Liberec  Husova Liberec Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"IVO","family":"SKALSKY","sequence":"additional","affiliation":[{"name":"Cardiology Centre, Institute for Clinical and Experimental Medicine  Videnska Prague Czech 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