High Frequency ECG to guide LV lead placement in CRT implantation
Research type
Research Study
Full title
Comparison of the response of Cardiac Resynchronisation Therapy (CRT) using high frequency ECG or Q-LV measurement guided optimisation for left ventricular, pacing site.
IRAS ID
287382
Contact name
Francisco Leyva-Leon
Contact email
Sponsor organisation
University Hospitals Birmingham
Duration of Study in the UK
1 years, 5 months, 30 days
Research summary
Cardiac resynchronisation therapy (CRT) is a treatment for heart failure patients with dyssynchronous hearts. CRT is proven treatment which is well evidenced within literature. However, not everyone responds to CRT treatment. Around 20 - 50% of patients do not respond to the treatment. Response is defined as structural remodelling (normalisation of the heart) or improvement in symptoms. A Long QRS duration, a measure of ventricular electrical contraction has been demonstrated to be a good indicator of patients likely to respond. Reducing this measure typically yields the best response, however there are still around 20% of patients who do not respond to treatment. When implanting a CRT device, targeting the latest electrical point of heart conduction using a measure called Q-LV yields the best response and narrowest QRS duration. This is a measure which involves measuring the delay from surface ECG onset to internal pacing site of the left ventricle to identify the longest delay.
It is theorised that these measures alone are not sensitive enough for patient selection and patient optimisation. High frequency ECG examines the QRS component of the ECG in greater detail, examining the temporal and spatial elements to provide greater resolution. It has been demonstrated in small or retrospective studies to improve patient selection and device optimisation. Our study is the first randomised trial to compare typical QRS duration and QLV measures with high frequency ECG when optimising left ventricular pacing site and examine patient response in regard to heart remodelling (structural normalisation) and patient symptoms.REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
23/EM/0110
Date of REC Opinion
8 Jul 2023
REC opinion
Further Information Favourable Opinion