{"id":"7d06d3f6dbd6","type":"article","url":"https://hartvaat.nl/2026/09/25/lead-v8-op-het-ecg-evalueert-linkervoorhartactivering-tijdens-bachmann-bundelpac/","title":"Lead V8 op het ECG evalueert linkervoorhartactivering tijdens Bachmann-bundelpacemaking","title_en":"Non-invasive assessment of left atrial activation using lead V8 during Bachmann bundle pacing.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euag276","source_url":"https://doi.org/10.1093/europace/euag276","authors":["Simon Mulier","Arno Fennema","Johan van Koll","Masih Mafi-Rad","Vidal Essebag","Atul Verma","Dominik Linz","Justin Luermans","Kevin Vernooy","Jacqueline Joza"],"significance":6,"published":"2026-10-03","source_date":"2026-09-25","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/digoxine-bij-af/"],"congress":"","summary_en":"This prospective study (n=100) demonstrates that repositioning the V5 ECG electrode to a V8 location (below the inferior left scapula) accurately reflects posterolateral left atrial activation timing, showing a strong correlation (r=0.94) with invasive coronary sinus mapping. During Bachmann bundle pacing (BBP), the V8-derived metrics significantly shortened activation intervals and successfully corrected interatrial block in 87% of patients. The findings offer electrophysiologists a practical, non-invasive tool to intraoperatively assess and optimize left atrial activation with BBP.","created":"2026-09-26T01:23:16Z","updated":"2026-09-26T01:23:16Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze prospectieve studie (n=100) toont aan dat het verplaatsen van de V5-elektrode naar de V8-positie (onder de linkeronderkant van het schouderblad) nauwkeurig de activatietijd van het posterolaterale linkervoorhart weerspiegelt, met een sterke correlatie (r=0,94) met invasief coronair sinus-mapping. Tijdens Bachmann-bundelpacemaking (BBP) leidde deze methode tot een significante verkorting van de activeringstijd en corrigeerde het interatriële blok in 87% van de patiënten. De bevinding biedt EP-specialisten een eenvoudige niet-invasieve manier om de effectiviteit van BBP intraoperatief te beoordelen en te optimaliseren.","abstract_original":"BACKGROUND AND AIMS: Bachmann bundle pacing (BBP) improves atrial synchrony by advancing LA activation, but quantifying inter-atrial synchronization remains challenging. This study evaluated whether lead V8 reflects posterolateral LA activation time and whether lead V8 can be used to assess the effect of BBP on LA activation. METHODS: Consecutive patients undergoing an electrophysiology study and ablation (Cohort 1) or BBP lead implantation (Cohort 2) were prospectively enrolled. Surface ECGs were recorded with the V5 electrode repositioned to the V8 location (2 cm below the inferior left scapula). LA activation was determined using the steepest negative downslope of the P-wave (NDAT-P-V8). Iso-V8 was defined as the time from P-wave onset to first positive deflection in lead V8. In Cohort 1, a coronary sinus (CS) catheter invasively determined activation timing at the posterolateral LA (mitral isthmus region). In Cohort 2, NDAT-P-V8 and iso-V8 were used to assess the effect of BBP on LA activation. RESULTS: In Cohort 1 (n=50), NDAT-P-V8 strongly correlated with the latest CS activation (r = 0.94, p<0.001). In Cohort 2 (n=50), lead V8 facilitated intra-procedural assessment of LA activation. IAB was corrected in 20/23 (87%), accompanied by shortening of NDAT-P-V8 (from 120±25ms to 82±17ms, p<0.001) and iso-V8 (from 51±22ms to 18±17ms, p<0.001), consistent with earlier LA activation. CONCLUSION: NDAT-P-V8 closely reflects the invasively determined timing of the posterolateral LA activation and provides a simple non-invasive marker to assess the effect of BBP on LA activation. Lead V8 may therefore help to assess and optimize atrial activation with BBP."}