{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:26:27Z","timestamp":1740137187756,"version":"3.37.3"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>It is not known whether the optimal atrioventricular (AV<jats:sub>opt<\/jats:sub>) delay varies between left ventricular (LV) pacing site during endocardial biventricular pacing (BiVP) and may therefore needs consideration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed the hemodynamic AV<jats:sub>opt<\/jats:sub> in patients with chronic heart failure undergoing endocardial LV lead implantation. AV<jats:sub>opt<\/jats:sub> was assessed during atrio\u2010BiVP\u00a0with a \u201croving LV lead.\u201d\u00a0Up to four locations were studied: mid\u2010lateral wall, mid\u2010septum (or a close alternative), site of greatest hemodynamic improvement, and LV lead implant site. The AV<jats:sub>opt<\/jats:sub> was compared to a fixed AV delay of 180\u2009ms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventeen patients were included (12 male, aged 66.5\u2009\u00b1\u200912.8 years, ejection fraction 26\u2009\u00b1\u20097%, 16 left bundle branch block or high percentage of right ventricular pacing [RVP], QRS duration 167\u2009\u00b1\u200927\u2009ms). In most locations (62\/63), AV<jats:sub>opt<\/jats:sub> increased systolic blood pressure during BiVP compared with RVP (relative improvement 6\u2009mmHg,\u00a0interquartile range [IQR] 4\u20139\u2009mmHg). Compared to a fixed AV delay, the hemodynamic improvement at AV<jats:sub>opt<\/jats:sub> was higher (1\u2009mmHg, IQR 0.2\u20132.6\u2009mmHg, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Within most patients (16\/17), we observed a difference in AV<jats:sub>opt<\/jats:sub> between pacing sites (median paced AV<jats:sub>opt<\/jats:sub> 209\u2009ms, IQR 117\u2013250). Within this range, the hemodynamic impact of these differences was small (median loss 0.6\u2009mmHg, IQR 0.1\u20132.6\u2009mmHg).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Within a patient, different endocardial LV lead locations have slightly different hemodynamic AV<jats:sub>opt<\/jats:sub> which are superior to a fixed AV delay. The hemodynamic consequence of applying an optimum from a different lead location is small.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15862","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T13:20:48Z","timestamp":1676380848000},"page":"1431-1440","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Variation in optimal hemodynamic atrio\u2010ventricular delay of biventricular pacing with different endocardial left ventricular lead locations using precision hemodynamics"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1518-2671","authenticated-orcid":false,"given":"Charles J. 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F.","family":"Cleland","sequence":"additional","affiliation":[{"name":"NHLI Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wajid","family":"Hussain","sequence":"additional","affiliation":[{"name":"Heart Rhythm Centre The Royal Brompton and Harefield Hospitals Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vias","family":"Markides","sequence":"additional","affiliation":[{"name":"Heart Rhythm Centre The Royal Brompton and Harefield Hospitals Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David G.","family":"Jones","sequence":"additional","affiliation":[{"name":"Heart Rhythm Centre The Royal Brompton and Harefield Hospitals Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca 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