The effect of anodal stimulation on V-V timing at varying V-V intervals.
We studied the effect of anodal capture at the ring electrode of the right ventricular (RV) lead on interventricular (V-V) timing during biventricular (BiV) pacing, in which left ventricular (LV) pacing was preceding RV pacing. The V-V interval was programmed from 80 to 4 ms (LV first) in the LV unipolar (LV tip--generator can) followed by the LV tip-RV ring pacing configuration. In the LV unipolar configuration, V-V programming leads to a continuous change in morphology of the QRS complex according to a change in collision of both activation fronts. When using the LV tip-RV ring configuration with anodal capture at the RV ring electrode no change in QRS morphology was recorded varying the V-V interval from 80 to 60 and 40 ms. However, at V-V intervals between 20 and 4 ms a change in morphology of the QRS complex was recorded, which was due to additional cathodal stimulation of the RV tip electrode during RV stimulation.
van Gelder
Berry M
BM
Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. carlgr@cze.nl
Bracke
Frank A
FA
Meijer
Albert
A
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012815:Signal Processing, Computer-Assisted; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000628:therapy; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology / Q000628:therapy