{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T21:30:55Z","timestamp":1785792655845,"version":"3.56.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T00:00:00Z","timestamp":1606348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009594","name":"P\u00e9csi Tudom\u00e1nyegyetem","doi-asserted-by":"publisher","award":["AOK\u2010KA\/2017"],"award-info":[{"award-number":["AOK\u2010KA\/2017"]}],"id":[{"id":"10.13039\/501100009594","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiac resynchronization therapy (CRT) is considered an efficient method to improve the left ventricular (LV) dysfunction with left bundle branch block. However, coronary venous anatomy is not appropriate in about 10% of the cases; thus other alternatives, such as epicardial lead implantation via minithoracotomy are needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>During the period 2007\u20102017, a total of\u00a057 patients were operated at our institute via left anterior minithoracotomy after an unsuccessful transvenous CRT. The best position of the LV epicardial electrode was determined by intraoperative epicardial mapping, that is locating the latest activation spot relative to the right ventricular (RV) electrode. The authors analyzed the survival by Kaplan\u2010Meier estimator with Tarone\u2010Ware equality test and multiple Cox regression analysis, the changes of the LV ejection fraction (LVEF) and dimensions, the development of the impedance and threshold of the LV epicardial electrode, the possible associations between the survival and intraoperative sensed RV\u2010LV activation delay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The intraoperative RV\u2010LV activation delay was 92.250 \u00b1 26.538\u00a0milliseconds. There were no intraoperative complications except ventricular fibrillation in three patients. Within 30 days there were neither wound healing complications nor pocket hematoma. There was no significant difference in survival with regard to gender or etiology, but significantly better survival was found in the cohort with intraoperative sensed RV\u2010LV activation delay\u00a0&gt;86\u00a0milliseconds. The LVEF and dimensions improved following the operation and continued to be improved in the survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CRT via minithoracotomy with epicardial mapping is a safe, efficient, simple, and reproducible second\u2010line alternative to the transvenous method.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14123","type":"journal-article","created":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T04:47:49Z","timestamp":1605242869000},"page":"101-109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cardiac resynchronization therapy with intraoperative epicardial mapping via minithoracotomy: 10 years\u2019 experience"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1820-5560","authenticated-orcid":false,"given":"L\u00e1szl\u00f3","family":"Hejjel","sequence":"first","affiliation":[{"name":"Heart Institute, 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