Assessment of ventricular electrical heterogeneity in left bundle branch pacing and left ventricular septal pacing by using various electrophysiological methods
Copyright policy )Assessment of ventricular electrical heterogeneity in left bundle branch pacing and left ventricular septal pacing by using various electrophysiological methods
AbstractIntroductionLeft bundle branch area pacing (LBBAP) comprises pacing at the left ventricular septum (LVSP) or left bundle branch (LBBP). The aim of the present study was to investigate the differences in ventricular electrical heterogeneity between LVSP, LBBP, right ventricular pacing (RVP) and intrinsic conduction with different dyssynchrony measures using the ECG, vectorcardiograpy, ECG belt, and Ultrahigh frequency (UHF‐)ECG.MethodsThirty‐seven patients with a pacemaker indication for bradycardia or cardiac resynchronization therapy underwent LBBAP implantation. ECG, vectorcardiogram, ECG belt and UHF‐ECG signals were recorded during RVP, LVSP and LBBP, and intrinsic activation. QRS duration (QRSd) was measured from the ECG, QRS area was calculated from the vectorcardiogram, LV activation time (LVAT) and standard deviation of activation time (SDAT) from ECG belt and electrical dyssynchrony (e‐DYS16) from UHF‐ECG.ResultsBoth LVSP and LBBP significantly reduced ventricular electrical heterogeneity as compared to underlying LBBB and RV pacing in terms of QRS area (p < .001), SDAT (p < .001), LVAT (p < .001) and e‐DYS16 (p < .001). QRSd was only reduced as compared to RV pacing(p < .001). QRS area was similar during LBBP and normal intrinsic conduction, e‐DYS16 was similar during LVSP and normal intrinsic conduction, whereas SDAT was similar for LVSP, LBBP and normal intrinsic conduction. For all these variables there was no significant difference between LVSP and LBBP.ConclusionBoth LVSP and LBBP resulted in a more synchronous LV activation than LBBB and RVP. Especially LBBP resulted in levels of LV synchrony comparable to normal intrinsic conduction.
- University of Copenhagen Denmark
- Fakultní nemocnice Královské Vinohrady Czech Republic
- Maastricht University, University Library Netherlands
- Charles University Czech Republic
- Czech Academy of Sciences Czech Republic
Male, Bundle of His, Time Factors, dyssynchrony, Bundle-Branch Block, Vectorcardiography, cardiac resynchronization therapy, Action Potentials, Ventricular Septum, Ventricular Function, Left, ACTIVATION, Cardiac Resynchronization Therapy, Electrocardiography, Predictive Value of Tests, Heart Rate, conduction system pacing, Humans, Cardiology - Radboud University Medical Center, Aged, Aged, 80 and over, DYSSYNCHRONY, left bundle branch area pacing, Cardiac Pacing, Artificial, Middle Aged, bradycardia pacing, Treatment Outcome, VECTORCARDIOGRAPHIC QRS AREA, CARDIAC RESYNCHRONIZATION THERAPY, Original Article, Female, Electrophysiologic Techniques, Cardiac
Male, Bundle of His, Time Factors, dyssynchrony, Bundle-Branch Block, Vectorcardiography, cardiac resynchronization therapy, Action Potentials, Ventricular Septum, Ventricular Function, Left, ACTIVATION, Cardiac Resynchronization Therapy, Electrocardiography, Predictive Value of Tests, Heart Rate, conduction system pacing, Humans, Cardiology - Radboud University Medical Center, Aged, Aged, 80 and over, DYSSYNCHRONY, left bundle branch area pacing, Cardiac Pacing, Artificial, Middle Aged, bradycardia pacing, Treatment Outcome, VECTORCARDIOGRAPHIC QRS AREA, CARDIAC RESYNCHRONIZATION THERAPY, Original Article, Female, Electrophysiologic Techniques, Cardiac
citations The total number of citations received by all articles of the researcher of interest.17 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 10% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Top 10% impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10%
Citations provided by BIP!Popularity provided by BIP!