Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization

0544671 - ÚPT 2022 RIV US eng J - Článek v odborném periodiku
Čurila, K. - Jurák, Pavel - Jastrzębski, M. - Prinzen, F. - Waldauf, P. - Halámek, Josef - Vernooy, K. - Smíšek, Radovan - Karch, J. - Plešinger, Filip - Moskal, P. - Sušánková, M. - Znojilová, L. - Heckman, L. - Viščor, Ivo - Vondra, Vlastimil - Leinveber, P. - Osmančík, P.
Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization.
Heart Rhythm. Roč. 18, č. 8 (2021), s. 1281-1289. ISSN 1547-5271. E-ISSN 1556-3871
Institucionální podpora: RVO:68081731
Klíčová slova: Depolarization duration * Dyssynchrony * His-bundle pacing * Left bundle branch pacing * Left ventricular septal myocardial pacing * Ultra-high-frequency electrocardiography
Obor OECD: Cardiac and Cardiovascular systems
Impakt faktor: 6.779, rok: 2021
Způsob publikování: Open access
https://www.sciencedirect.com/science/article/pii/S1547527121004021?via%3Dihub

Background: Nonselective His-bundle pacing (nsHBp), nonselective left bundle branch pacing (nsLBBp), and left ventricular septal myocardial pacing (LVSP) are recognized as physiological pacing techniques. Objective: The purpose of this study was to compare differences in ventricular depolarization between these techniques using ultra-high-frequency electrocardiography (UHF-ECG). Methods: In patients with bradycardia, nsHBp, nsLBBp (confirmed concomitant left bundle branch [LBB] and myocardial capture), and LVSP (pacing in left ventricular [LV] septal position without proven LBB capture) were performed. Timings of ventricular activations in precordial leads were displayed using UHF-ECG, and electrical dyssynchrony (e-DYS) was calculated as the difference between the first and last activation. Duration of local depolarization (Vd) was determined as width of the UHF-QRS complex at 50% of its amplitude. Results: In 68 patients, data were collected during nsLBBp (35), LVSP (96), and nsHBp (55). nsLBBp resulted in larger e-DYS than did LVSP and nsHBp [– 24 ms (–28,–19) vs –12 ms (–16,–9) vs 10 ms (7,14), respectively, P <.001]. nsLBBp produced similar values of Vd in leads V5–V8 (36-43 ms vs 38-43 ms, P = NS in all leads) but longer Vd in leads V1–V4 (47–59 ms vs 41–44 ms, P <.05) as nsHBp. LVSP caused prolonged Vd in leads V1–V8 compared to nsHBp and longer Vd in leads V5–V8 compared to nsLBBp (44–51 ms vs 36–43 ms, P <.05) regardless of R-wave peak time in lead V5 or QRS morphology in lead V1 present during LVSP. Conclusion: nslbbp preserves physiological LV depolarization but increases interventricular electrical dyssynchrony. LV lateral wall depolarization during LVSP is prolonged, but interventricular synchrony is preserved.
Trvalý link: http://hdl.handle.net/11104/0321510