Skip to main content
. 2021 Sep 12;8(6):5222–5236. doi: 10.1002/ehf2.13601

Figure 2.

Figure 2

Demonstration of shortening of time‐to‐peak dP/dt (Td) with biventricular pacing and myocardial synergy with simultaneous pacing of the RV and the LV (resynchronization). (A) Left bundle branch block (LBBB) with electrical activation patterns showing a sequence of septal‐anterior–posterior‐lateral activation with dyssynergistic septal and lateral wall contraction patterns with pressure rise reaching its peak just before aortic valve opening. Red arrow: Septal beaking. Grey arrow: shortening of the lateral segment. Green arrow: onset of ejection. (B) Biventricular pacing from an apical positioned left ventricular epicardial electrode demonstrates a simultaneous sequence of activation with synergistic septal and lateral wall contraction patterns and peak left ventricular pressure rise (that occur before aortic valve opening). Grey arrow: shortening of the lateral segment. Green arrow: onset of ejection. V1, ECG lead; RV, right ventricle; LV, left ventricle; LVP, left ventricular pressure; LV dP/dt, LV pressure derivative; Td, time‐to‐peak LV dP/dt.