Real-time assessment of inter and intraventricular synchrony in cardiac resynchronization therapy with left bundle branch pacing using ECGi and low-frequency QRS analysis

Sales-Belles, Clara (Universidad de Zaragoza) ; Mincholé, Ana (Universidad de Zaragoza) ; Cabrera-Ramos, Mercedes (Universidad de Zaragoza) ; Melero-Polo, Jorge (Universidad de Zaragoza) ; Pueyo, Esther (Universidad de Zaragoza) ; Ramos Maqueda, Javier (Universidad de Zaragoza)

Resumen: Introduction: Left bundle branch pacing (LBBP) is an alternative to conventional biventricular pacing for cardiac resynchronization therapy (CRT).
Methods: A 76-year-old male was referred for CRT via left bundle branch pacing (LBBP). We present the real-time characterization of the transition from intrinsic left bundle branch block (LBBB) to sequential pacing modalities: right ventricular septal pacing (RVSP), left ventricular septal pacing (LVSP), and finally LBBP. Epicardial activation maps from electrocardiographic imaging (ECGi) and low-frequency (LF) QRS analysis were used to provide complementary insights into interand intraventricular synchrony.
Results: LVSP, LBBP, and anodal capture improved activation compared with baseline, with LBBP achieving the greatest improvements in interventricular and LV intraventricular synchrony despite higher RV dispersion.
Conclusion: These findings highlight ECGi and LF QRS as valuable tools to guide CRT.

Idioma: Inglés

DOI: 10.1007/s10840-026-02288-9

Año: 2026

Publicado en: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY (2026), [6 pp.]
ISSN: 1383-875X

Financiación: info:eu-repo/grantAgreement/ES/AEI/PID2021-128972OA-I00
Financiación: info:eu-repo/grantAgreement/ES/DGA/LMP 94-21
Financiación: info:eu-repo/grantAgreement/ES/DGA/T39-23R
Financiación: info:eu-repo/grantAgreement/ES/MICINN/AEI/CNS2022-135899
Financiación: info:eu-repo/grantAgreement/ES/MICINN/PID2022-140556OB-I00
Financiación: info:eu-repo/grantAgreement/ES/MICINN/RYC2019-027420-I
Financiación: info:eu-repo/grantAgreement/EUR/MICINN/TED2021-130459B-I00

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Área Teoría Señal y Comunicac. (Dpto. Ingeniería Electrón.Com.)