Physiology-Based Electrocardiographic Criteria for Left Bundle Branch Capture

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F21%3A43921228" target="_blank" >RIV/00216208:11120/21:43921228 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064173:_____/21:N0000085

Výsledek na webu

<a href="https://doi.org/10.1016/j.hrthm.2021.02.021" target="_blank" >https://doi.org/10.1016/j.hrthm.2021.02.021</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.hrthm.2021.02.021" target="_blank" >10.1016/j.hrthm.2021.02.021</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Physiology-Based Electrocardiographic Criteria for Left Bundle Branch Capture

Popis výsledku v původním jazyce

BACKGROUND: During left bundle branch (LBB) area pacing, it is important to confirm that the capture of the LBB is achieved, not just the capture of only the adjacent left ventricular (LV) myocardium. OBJECTIVE: Our aim was to establish ECG criteria for LBB capture. We hypothesized that since LBB pacing results in physiologic depolarization of the LV then the native QRS can serve as a reference for the diagnosis of LBB capture in the same patient. METHODS: Only patients with evidence of LBB capture (QRS morphology transition) were included. Several QRS characteristics were compared between the native rhythm and different types of LBB area capture. RESULTS: A total of 357 ECGs (124 patients) were analyzed: 118 with native rhythm, 124 with non-selective LBB capture, 69 with selective LBB capture and 46 with LV septal capture. Our hypotheses that during LBB capture the paced V6 R-wave peak time (RWPT, measured from QRS onset) equals the native V6 RWPT and that the paced V6 RWPT (measured from the stimulus) equals the LBB potential to V6 R-wave peak interval were positively validated. Criteria based on these rules had sensitivity and specificity of 88.2-98.0% and 85.7-95.4%, respectively. Moreover, 100% specific V6 RWPT cut-off for LBB capture diagnosis in patients with narrow QRS/right bundle branch block was determined to be 74 ms. CONCLUSION: We showed equivalency of LV activation times in ECG during native and paced LBB conduction, consequently, if V6 RWPT is longer during pacing, this is indicative of lack of LBB capture.

Název v anglickém jazyce

Physiology-Based Electrocardiographic Criteria for Left Bundle Branch Capture

Popis výsledku anglicky

BACKGROUND: During left bundle branch (LBB) area pacing, it is important to confirm that the capture of the LBB is achieved, not just the capture of only the adjacent left ventricular (LV) myocardium. OBJECTIVE: Our aim was to establish ECG criteria for LBB capture. We hypothesized that since LBB pacing results in physiologic depolarization of the LV then the native QRS can serve as a reference for the diagnosis of LBB capture in the same patient. METHODS: Only patients with evidence of LBB capture (QRS morphology transition) were included. Several QRS characteristics were compared between the native rhythm and different types of LBB area capture. RESULTS: A total of 357 ECGs (124 patients) were analyzed: 118 with native rhythm, 124 with non-selective LBB capture, 69 with selective LBB capture and 46 with LV septal capture. Our hypotheses that during LBB capture the paced V6 R-wave peak time (RWPT, measured from QRS onset) equals the native V6 RWPT and that the paced V6 RWPT (measured from the stimulus) equals the LBB potential to V6 R-wave peak interval were positively validated. Criteria based on these rules had sensitivity and specificity of 88.2-98.0% and 85.7-95.4%, respectively. Moreover, 100% specific V6 RWPT cut-off for LBB capture diagnosis in patients with narrow QRS/right bundle branch block was determined to be 74 ms. CONCLUSION: We showed equivalency of LV activation times in ECG during native and paced LBB conduction, consequently, if V6 RWPT is longer during pacing, this is indicative of lack of LBB capture.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

S - Specificky vyzkum na vysokych skolach<br>I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Heart Rhythm

ISSN

1547-5271

e-ISSN

—

Svazek periodika

18

Číslo periodika v rámci svazku

6

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

9

Strana od-do

935-943

Kód UT WoS článku

000656705500015

EID výsledku v databázi Scopus

2-s2.0-85104571494