title: A review of multisite pacing to achieve cardiac resynchronization therapy.
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.
authors.affiliation: Cardiac Department, Guy's and St Thomas' Hospitals, London SE1 7EH, UK c.rinaldi@virgin.net.
authors.forename: Christopher Aldo
authors.initials: CA
authors.lastname: Rinaldi
authors.affiliation: Cardiology Service, University Hospital of Geneva, Rue Gabrielle Perret Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Haran
authors.initials: H
authors.lastname: Burri
authors.affiliation: Department of Medicine and Research Center, Montreal Heart Institute and Université de Montréal, 5000 Belanger Street, Montreal, Quebec, QC, Canada.
authors.forename: Bernard
authors.initials: B
authors.lastname: Thibault
authors.affiliation: Department of Experimental and Applied Medicine, Section of Cardiovascular Diseases, University of Brescia, Brescia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Curnis
authors.affiliation: Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK.
authors.forename: Archana
authors.initials: A
authors.lastname: Rao
authors.affiliation: Nouvelles Cliniques Nantaises, Nantes, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gras
authors.affiliation: Department of Cardiology and Electrophysiology, Kerckhoff-Klinik GmbH, Benekestrasse 2-8, D-61231 Bad Nauheim, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Sperzel
authors.affiliation: Massachusetts General Hospital Heart Center, Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA.
authors.forename: Jagmeet P
authors.initials: JP
authors.lastname: Singh
authors.affiliation: Institute of Cardiology, University of Bologna, Bologna 40138, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Biffi
authors.affiliation: Service de Rythmologie, Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II, Avenue de Magellan, Bordeaux-Pessac 33604, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.affiliation: Département de Cardiologie et Maladies Vasculaires, CHU Pontchaillou 2, rue Henri le Guilloux, 35033 Rennes Cédex 09, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Leclercq
mesh_terms: D000818:Animals; D002037:Bundle-Branch Block / Q000150:complications* / Q000517:prevention & control*; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects* / Q000379:methods*; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000150:complications* / Q000517:prevention & control*; D006801:Humans; D018579:Patient Selection; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology / Q000517:prevention & control
keywords: Cardiac resynchronization therapy; Dyssynchrony; Heart failure; Multisite pacing; Pacemaker