A review of multisite pacing to achieve cardiac resynchronization therapy

Europace. 2015 Jan;17(1):7-17. doi: 10.1093/europace/euu197. Epub 2014 Sep 11.

Abstract

Non-response to cardiac resynchronization therapy remains a significant problem in up to 30% of patients. Multisite stimulation has emerged as a way of potentially overcoming non-response. This may be achieved by the use of multiple leads placed within the coronary sinus and its tributaries (dual-vein pacing) or more recently by the use of multipolar (quadripolar) left ventricular pacing leads which can deliver pacing stimuli at multiple sites within the same vein. This review covers the role of multisite pacing including the interaction with the underlying pathophysiology, the current and planned studies, and the potential pitfalls of this technology.

Keywords: Cardiac resynchronization therapy; Dyssynchrony; Heart failure; Multisite pacing; Pacemaker.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Bundle-Branch Block / complications*
  • Bundle-Branch Block / prevention & control*
  • Cardiac Resynchronization Therapy / adverse effects*
  • Cardiac Resynchronization Therapy / methods*
  • Evidence-Based Medicine
  • Heart Failure / complications*
  • Heart Failure / prevention & control*
  • Humans
  • Patient Selection
  • Treatment Outcome
  • Ventricular Fibrillation / etiology
  • Ventricular Fibrillation / prevention & control