Skip to main content

Research Repository

Advanced Search

The HF-CGM study: An analysis of cardiogoniometric axes in patients with cardiac resynchronization therapy

Clark, Andrew L.; Hoye, Angela; Beddoes, Gowan; Nikolaidou, Theodora; Brown, Oliver I.


Andrew L. Clark

Angela Hoye

Gowan Beddoes

Theodora Nikolaidou

Oliver I. Brown


Goal: The HF-CGM is a proof-of-principle study to investigate whether cardiogoniometry (CGM), a three-dimensional electrocardiographic method, can differentiate between pacing modes in patients with cardiac resynchronization therapy (CRT). Methods: At a tertiary cardiology center, CGM recordings were performed using four pacing modes: no pacing; right ventricular (RV) pacing; left ventricular (LV) pacing, and biventricular (BIV) pacing. Three orthogonal CGM planes orientated to the long axis (XY), the frontal plane (YZ), and the short axis (XZ) of the heart were constructed, and the direction of the QRS-axis was calculated for each pacing mode in each plane. During BIV pacing, the direction of CGM QRS-axis was compared between patients with optimal and nonoptimal 12-lead pacing variables. Results: Twenty-two participants (aged 71.5 ± 10.8; 77.3% male, LVEF 29 ± 7%) were consecutively recruited. Only QRS-axis measured in the XY plane could significantly distinguish between all three pacing modes versus no pacing. Mean QRS-axis in the XY plane with pacing off and during RV pacing was leftward and basal; LV pacing was apical; and BIV pacing was rightward and basal. There was a statistically significant difference in the direction of the QRS-axis between patients with optimal versus nonoptimal paced QRS morphology in the XY plane (rightward and basal versus inconsistent). Significance : CGM recorded in the XY plane can accurately detect differences between ventricular pacing sites. It may also be able to identify patients with a CRT device in situ who have optimal response.


Clark, A. L., Hoye, A., Beddoes, G., Nikolaidou, T., & Brown, O. I. (2018). The HF-CGM study: An analysis of cardiogoniometric axes in patients with cardiac resynchronization therapy. IEEE transactions on bio-medical engineering / Bio-medical Engineering Group, 65(8), 1711-1716.

Journal Article Type Article
Acceptance Date Oct 10, 2017
Online Publication Date Nov 2, 2017
Publication Date 2018-08
Deposit Date Jul 3, 2018
Publicly Available Date Nov 3, 2018
Journal IEEE Transactions on Biomedical Engineering
Print ISSN 0018-9294
Publisher Institute of Electrical and Electronics Engineers
Peer Reviewed Peer Reviewed
Volume 65
Issue 8
Pages 1711-1716
Public URL
Publisher URL
Contract Date Jul 5, 2018


Article (540 Kb)

Copyright Statement
© 2018 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.

You might also like

Downloadable Citations