In vivo electromechanical assessment of heart failure patients with prolonged QRS duration

Wilco Kroon, Joost Lumens, Mark Potse, Daniel Suerder, Catherine Klersy, Francois Regoli, Romina Murzilli, Tiziano Moccetti, Tammo Delhaas, Rolf Krause, Frits W. Prinzen, Angelo Auricchio

Research output: Contribution to journalArticlepeer-review


Background Combined measurement of electrical activation and mechanical dyssynchrony in heart failure (HF) patients is scarce but may contain important mechanistic and diagnostic clues. Objective The purpose of this study was to characterize the electromechanical (EM) coupling in HF patients with prolonged QRS duration. Methods Ten patients with QRS width >120 ms underwent left ventricular (LV) electroanatomic contact mapping using the Noga® XP system (Biosense Webster). Recorded voltages during the cardiac cycle were converted to maps of depolarization time (TD). Electrode positions were tracked and converted into maps of time-to-peak shortening (TPS) using custom-made deformation analysis software. Correlation analysis was performed between the 2 maps to quantify EM coupling. Simulations with the CircAdapt cardiovascular system model were performed to mechanistically unravel the observed relation between TD and TPS. Results The delay between earliest LV electrical activation and peak shortening differed considerably between patients (TPSmin-TDmin = 360 ± 73 ms). On average, total mechanical dyssynchrony exceeded total electrical activation (ΔTPS = 177 ± 47 ms vs ΔTD = 93 ± 24 ms, P

Original languageEnglish
Pages (from-to)1259-1267
Number of pages9
JournalHeart Rhythm
Issue number6
Publication statusPublished - Jun 1 2015


  • Cardiacresynchronizationtherap
  • Electromechanicaldelay
  • Excitationcontraction coupling
  • Heart failure
  • Leftbundlebranchblock
  • Mapping
  • QRSduration

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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