{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:19:02Z","timestamp":1780543142220,"version":"3.54.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>In contrast to patients with left bundle branch block (LBBB), heart failure patients with narrow QRS and nonspecific intraventricular conduction delay (NICD) display a relatively limited response to cardiac resynchronization therapy. We sought to compare left ventricular (LV) activation patterns in heart failure patients with narrow QRS and NICD to patients with LBBB using high-density electroanatomic activation maps.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Fifty-two heart failure patients (narrow QRS [n=18], LBBB [n=11], NICD [n=23]) underwent 3-dimensional electroanatomic mapping with a high density of mapping points (387\u00b1349 LV). Adjunctive scar imaging was available in 37 (71%) patients and was analyzed in relation to activation maps. LBBB patients typically demonstrated (1) a single LV breakthrough at the septum (38\u00b115 ms post-QRS onset); (2) prolonged right-to-left transseptal activation with absence of direct LV Purkinje activity; (3) homogeneous propagation within the LV cavity; and (4) latest activation at the basal lateral LV. In comparison, both NICD and narrow QRS patients demonstrated (1) multiple LV breakthroughs along the posterior or anterior fascicles: narrow QRS versus LBBB, 5\u00b12 versus 1\u00b11;\n              <jats:italic>P<\/jats:italic>\n              =0.0004; NICD versus LBBB, 4\u00b12 versus 1\u00b11;\n              <jats:italic>P<\/jats:italic>\n              =0.001); (2) evidence of early\/pre-QRS LV electrograms with Purkinje potentials; (3) rapid propagation in narrow QRS patients and more heterogeneous propagation in NICD patients; and (4) presence of limited areas of late activation associated with LV scar with high interindividual heterogeneity.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In contrast to LBBB patients, narrow QRS and NICD patients are characterized by distinct mechanisms of LV activation, which may predict poor response to cardiac resynchronization therapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.117.005073","type":"journal-article","created":{"date-parts":[[2017,6,20]],"date-time":"2017-06-20T00:50:25Z","timestamp":1497919825000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Distinctive Left Ventricular Activations Associated With ECG Pattern in Heart Failure Patients"],"prefix":"10.1161","volume":"10","author":[{"given":"Nicolas","family":"Derval","sequence":"first","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josselin","family":"Duchateau","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saagar","family":"Mahida","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Eschalier","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Sacher","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"Lumens","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Cochet","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Denis","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Pillois","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seigo","family":"Yamashita","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Komatsu","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Ploux","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Amraoui","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adlane","family":"Zemmoura","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Ritter","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e9l\u00e8ze","family":"Hocini","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Haissaguerre","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Ja\u00efs","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Bordachar","sequence":"additional","affiliation":[{"name":"From the H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU Bordeaux, LIRYC, L\u2019Institut de rythmologie et mod\u00e9lisation cardiaque, Universit\u00e9 de Bordeaux, France (N.D., J.D., F.S., J.L., H.C., A.D., X.P., S.Y., Y.K., S.P., S.A., A.Z., P.R., M. Hocini, M. Haissaguerre, P.J., P.B.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (S.M.); CHU Clermont-Ferrand, Clermont-Ferrand, France (R.E.); and Maastricht University Medical Center, The Netherlands (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.000112"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.097709"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.11.014"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.001239"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306687"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht150"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706695"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.113.000380"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.960898"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.01.023"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.013"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc0402.102975"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12052"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.11.025"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000115583.20268.E1"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000118502.91105.F6"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.69.5.914"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.093"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.90.1.44"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.90.1.17"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.110.958124"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.12.031"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.03.006"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.115.003744"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.060"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.112.000191"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.117.005073","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T23:26:31Z","timestamp":1715556391000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.117.005073"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1161\/CIRCEP.117.005073"],"URL":"https:\/\/doi.org\/10.1161\/circep.117.005073","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6]]},"assertion":[{"value":"2017-01-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-04-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e005073"}}