{
  "abstract": "Aims\n\nElectrical ventricular dyssynchrony is a hallmark of intraventricular conduction disease in heart failure with reduced ejection fraction. Although cardiac resynchronization therapy (CRT) is effective, a proportion of patients with electrical dyssynchrony evidenced by an electrocardiogram (ECG) remain non-responders. Besides the QRS duration, visualization and quantification of the depolarization sequence could contribute to improving CRT response. The study aimed to evaluate the CineECG-derived mean temporo-spatial isochrone trajectory of depolarization in CRT patients.Methods and results\n\nAmong the adult cohort of 121 patients who underwent CRT implantation, there were 93 (33% female) responders and 28 (7% female) non-responders. ECGs recorded before and immediately after CRT implantation were collected and analysed using the CineECG modality with a generic heart/torso model. The CineECG-derived path directions were computed for the QRS on anteroposterior, interventricular, and apicobasal axes within the cardiac anatomy. Spatial depolarization characteristics were tested for the association with left ventricle reverse-remodelling at 6-month follow-up. The pre-implantation depolarization sequence was predominantly from the right to the left ventricle, and after the CRT implant, it has been transformed into an apicobasal direction. In multivariate logistic regression, the pre-implant QRS duration, apicobasal depolarization gradient, and CRT-induced QRS shortening independently predicted CRT response. The Akaike information criterion indicated that combining all three yielded the strongest predictive model.Conclusion\n\nCineECG-derived depolarization gradients, which reflect ventricular activation sequence, changed significantly after CRT, and the pre-implantation apicobasal gradient independently predicted echocardiographic outcome, with a less pronounced gradient associated with better haemodynamic response.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Sitna Sq. 3105, Kladno 272 01, Czech Republic.",
    "Department of Cardiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague 140 21, Czech Republic.",
    "Center for Digital Medicine and Robotics, Jagiellonian University Medical College, Kopernika 7E, Krakow 31-034, Poland.",
    "Department of Cardiology, Cardiocenter, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Ruska 87, Prague 100 00, Czech Republic.",
    "International Clinical Research Center, St. Anne's University Hospital, Pekarska 53, Brno 602 00, Czech Republic."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Ksenia Sedova",
      "orcid": "0000-0003-0723-2675"
    },
    {
      "affs": [
        0
      ],
      "name": "Jan Azarov",
      "orcid": "0000-0003-1779-273X"
    },
    {
      "affs": [
        2
      ],
      "name": "Peter M Van Dam",
      "orcid": "0000-0002-7962-1760"
    },
    {
      "affs": [
        3
      ],
      "name": "Karol Curila",
      "orcid": "0000-0003-3523-6358"
    },
    {
      "affs": [
        4
      ],
      "name": "Pavel Leinveber",
      "orcid": "0000-0001-7267-4408"
    },
    {
      "affs": [
        1
      ],
      "name": "Josef Kautzner",
      "orcid": "0000-0002-1632-6182"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/68cq213a0yyzj.bib",
  "cited_by": 0,
  "doi": "10.1093/ehjopen/oeag165",
  "fulltext_url": "https://europepmc.org/articles/PMC13689692",
  "id": "68cq213a0yyzj",
  "issns": [
    "2752-4191"
  ],
  "landing_url": "https://europepmc.org/article/MED/42923679",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Cardiac pacing and defibrillation studies"
    ]
  ],
  "openalex": "W7220935119",
  "pdf_url": "https://europepmc.org/articles/PMC13689692?pdf=render",
  "pmcid": "PMC13689692",
  "pmid": "42923679",
  "published": "2026-09-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/68cq213a0yyzj.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:02Z",
      "native_id": "MED:42923679",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42923679"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac pacing and defibrillation studies",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Optimal depolarization sequence for cardiac resynchronization therapy patients.",
  "title_text": "Optimal depolarization sequence for cardiac resynchronization therapy patients.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:02Z",
  "url": "https://research.draconitic.com/paper/68cq213a0yyzj",
  "venue": "European heart journal open",
  "versions": []
}