PMID- 29023821
OWN - NLM
STAT- MEDLINE
DCOM- 20180917
LR  - 20220330
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 40
IP  - 12
DP  - 2017 Dec
TI  - Optimization of coronary sinus lead placement targeted to the longest 
      right-to-left delay in patients undergoing cardiac resynchronization therapy: The 
      Optimal Pacing SITE 2 (OPSITE 2) acute study and protocol.
PG  - 1350-1357
LID - 10.1111/pace.13212 [doi]
AB  - AIMS: Left ventricular (LV) lead positioning at the site of delayed electrical 
      activation is associated with better response to cardiac resynchronization 
      therapy (CRT). We hypothesized that a long electrical conduction delay between 
      right ventricular (RV) and coronary sinus (CS) leads during RV pacing (RLD index) 
      is correlated with a better clinical outcome METHODS AND RESULTS: RLD is measured 
      intraprocedurally, during RV pacing, as the time interval between the 
      intracardiac electrograms of RV and CS leads. Initially, we did a 
      prove-of-concept, feasibility, acute study in 97 patients who underwent CRT 
      implantation. The CS lead position was assessed in the 40 degrees  right anterior oblique 
      and 40 degrees  left anterior oblique views and assigned to one of 11 prespecified 
      segments of a schematic eyeball depiction of the LV walls. Acute outcomes were 
      QRS width during biventricular (BIV) pacing. The longest RLD were found in the 
      basal and mid lateral segments; these accounted for 82% and 78%, respectively, of 
      the total QRS width (%RLD). %RLD was inversely correlated with BIV-paced QRS 
      (P  =  0.0001). A similar slope was present either in the 78 patients with 
      preserved atrioventricular (AV) conduction and in the 19 without AV conduction 
      (- 0.34 vs - 0.27, P  =  0.7). CONCLUSION: We showed that RLD can be used to 
      guide lead placement at the time of CRT implantation and that it is correlated 
      with BIV-QRS width, an indirect predictor of clinical outcome. Based on these 
      findings we started the prospective, multicenter Optimal Pacing SITE 2 (OPSITE 2) 
      trial with the objective to demonstrate a relationship between RLD and clinical 
      outcomes assessed as death, hospitalization for heart failure, New York Heart 
      Association class, and clinical composite score. The protocol is provided.
CI  - (c) 2017 Wiley Periodicals, Inc.
FAU - Oddone, Daniele
AU  - Oddone D
AD  - Ospedali del Tigullio, Lavagna, Italy.
FAU - Solari, Diana
AU  - Solari D
AD  - Ospedali del Tigullio, Lavagna, Italy.
FAU - Nangah, Rene
AU  - Nangah R
AD  - Ospedale Civile, Portogruaro, Italy.
FAU - Arena, Giuseppe
AU  - Arena G
AD  - Ospedale Apuane, Massa, Italy.
FAU - Mureddu, Roberto
AU  - Mureddu R
AD  - Ospedale di Imperia, Imperia, Italy.
FAU - Giorgi, Davide
AU  - Giorgi D
AD  - Ospedale San Luca, Lucca, Italy.
FAU - Sitta, Nadir
AU  - Sitta N
AD  - Ospedale di Conegliano, Conegliano, Italy.
FAU - Bottoni, Nicola
AU  - Bottoni N
AD  - Arcispedale S.Maria Nuova, Reggio Emilia, Italy.
FAU - Senatore, Gaetano
AU  - Senatore G
AD  - Ospedale Civile, Cirie, Italy.
FAU - Giaccardi, Marzia
AU  - Giaccardi M
AD  - Ospedale Santa maria Nuova, Firenze, Italy.
FAU - Giammaria, Massimo
AU  - Giammaria M
AUID- ORCID: 0000-0001-5070-7715
AD  - Ospedale Maria Vittoria, Torino, Italy.
FAU - Themistoclakis, Sakis
AU  - Themistoclakis S
AD  - Ospedale dell'Angelo, Mestre, Italy.
FAU - Laffi, Mattia
AU  - Laffi M
AD  - Ospedale Villa Scassi, Genova, Italy.
FAU - Cipolla, Eliana
AU  - Cipolla E
AD  - Abbott, Italy.
FAU - Di Lorenzo, Fabio
AU  - Di Lorenzo F
AD  - Abbott, Italy.
FAU - Carpi, Romina
AU  - Carpi R
AD  - Abbott, Italy.
FAU - Brignole, Michele
AU  - Brignole M
AUID- ORCID: 0000-0002-1845-5607
AD  - Ospedali del Tigullio, Lavagna, Italy.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20171116
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Cardiac Resynchronization Therapy/*methods/standards
MH  - Clinical Protocols
MH  - *Coronary Sinus
MH  - Female
MH  - Heart Failure/physiopathology/*therapy
MH  - Heart Ventricles/*physiopathology
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Time Factors
OTO - NOTNLM
OT  - cardiac resynchronization therapy
OT  - coronary sinus lead position
OT  - electrical delay
OT  - right to left delay
EDAT- 2017/10/13 06:00
MHDA- 2018/09/18 06:00
CRDT- 2017/10/13 06:00
PHST- 2017/06/28 00:00 [received]
PHST- 2017/09/19 00:00 [revised]
PHST- 2017/10/01 00:00 [accepted]
PHST- 2017/10/13 06:00 [pubmed]
PHST- 2018/09/18 06:00 [medline]
PHST- 2017/10/13 06:00 [entrez]
AID - 10.1111/pace.13212 [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2017 Dec;40(12):1350-1357. doi: 10.1111/pace.13212. 
      Epub 2017 Nov 16.