Ventricular Dyssynchrony and Pacing-induced Cardiomyopathy in Patients with Pacemakers, the Utility of Ultra-high-frequency ECG and Other Dyssynchrony Assessment Tools

0560697 - ÚPT 2023 RIV GB eng J - Journal Article
Mizner, J. - Jurák, Pavel - Línková, H. - Smíšek, Radovan - Čurila, K.
Ventricular Dyssynchrony and Pacing-induced Cardiomyopathy in Patients with Pacemakers, the Utility of Ultra-high-frequency ECG and Other Dyssynchrony Assessment Tools.
Arrhythmia & Electrophysiology Review. Roč. 11, 28 July 2022 (2022), č. článku e17. ISSN 2050-3369. E-ISSN 2050-3377
R&D Projects: GA MZd(CZ) NU21-02-00584
Institutional support: RVO:68081731
Keywords : Pacing-induced cardiomyopathy * cardiac pacing * ventricular dyssynchrony assessment * ultra-high-frequency ECG
OECD category: Cardiac and Cardiovascular systems
Impact factor: 3, year: 2022
Method of publishing: Open access
https://www.aerjournal.com/articles/ventricular-dyssynchrony-and-pacing-induced-cardiomyopathy-patients-pacemakers-utility

The majority of patients tolerate right ventricular pacing well, however, some patients manifest signs of heart failure after pacemaker implantation and develop pacing-induced cardiomyopathy. This is a consequence of non-physiological ventricular activation bypassing the conduction system. Ventricular dyssynchrony was identified as one of the main factors responsible for pacing-induced cardiomyopathy development. Currently, methods that would allow rapid and reliable ventricular dyssynchrony assessment, ideally during the implant procedure, are lacking. Paced QRS duration is an imperfect marker of dyssynchrony, and methods based on body surface mapping, electrocardiographic imaging or echocardiography are laborious and time-consuming, and can be difficult to use during the implantation procedure. However, the ventricular activation sequence can be readily displayed from the chest leads using an ultra-high-frequency ECG. It can be performed during the implantation procedure to visualise ventricular depolarisation and resultant ventricular dyssynchrony during pacing. This information can assist the electrophysiologist in selecting a pacing location that avoids dyssynchronous ventricular activation.
Permanent Link: https://hdl.handle.net/11104/0334142