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.

1st Department of Cardiology Interventional Electrocardiology and Hypertension Jagiellonian University Medical College Krakow Poland

Brno University of Technology Faculty of Electrical Engineering and Communication Department of Biomedical Engineering Technická 12 Brno Czech Republic

Cardiocenter 3rd Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady Prague Czech Republic

Department of Anesthesia and Intensive Care Charles University and University Hospital Kralovske Vinohrady Prague Czech Republic

Department of Cardiology Cardiovascular Research Institute Maastricht Maastricht University Medical Center Maastricht the Netherlands

Department of Physiology Cardiovascular Research Institute Maastricht Maastricht University Medical Center Maastricht the Netherlands

Institute of Scientific Instruments the Czech Academy of Sciences Brno Czech Republic

International Clinical Research Center St Anne's University Hospital Brno Czech Republic

000      

00000naa a2200000 a 4500

001      

bmc22012314

003      

CZ-PrNML

005      

20220606132339.0

007      

ta

008      

220425s2021 xxu f 000 0|eng||

009      

AR

024    7_

$a 10.1016/j.hrthm.2021.04.025 $2 doi

035    __

$a (PubMed)33930549

040    __

$a ABA008 $b cze $d ABA008 $e AACR2

041    0_

$a eng

044    __

$a xxu

100    1_

$a Curila, Karol $u Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. Electronic address: karol.curila@fnkv.cz

245    10

$a Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization / $c K. Curila, P. Jurak, M. Jastrzebski, F. Prinzen, P. Waldauf, J. Halamek, K. Vernooy, R. Smisek, J. Karch, F. Plesinger, P. Moskal, M. Susankova, L. Znojilova, L. Heckman, I. Viscor, V. Vondra, P. Leinveber, P. Osmancik

520    9_

$a 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.

650    _2

$a senioři $7 D000368

650    _2

$a Hisův svazek $x patofyziologie $7 D002036

650    _2

$a blokáda Tawarova raménka $x patofyziologie $x terapie $7 D002037

650    _2

$a kardiostimulace umělá $x metody $7 D002304

650    _2

$a elektrokardiografie $x metody $7 D004562

650    _2

$a ženské pohlaví $7 D005260

650    _2

$a následné studie $7 D005500

650    _2

$a srdeční komory $x patofyziologie $7 D006352

650    _2

$a lidé $7 D006801

650    _2

$a mužské pohlaví $7 D008297

650    _2

$a prospektivní studie $7 D011446

650    _2

$a funkce levé komory srdeční $x fyziologie $7 D016277

650    _2

$a mezikomorová přepážka $x patofyziologie $7 D054088

655    _2

$a srovnávací studie $7 D003160

655    _2

$a časopisecké články $7 D016428

655    _2

$a práce podpořená grantem $7 D013485

700    1_

$a Jurak, Pavel $u Institute of Scientific Instruments, the Czech Academy of Sciences, Brno, Czech Republic

700    1_

$a Jastrzebski, Marek $u First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland

700    1_

$a Prinzen, Frits $u Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands

700    1_

$a Waldauf, Petr $u Department of Anesthesia and Intensive Care, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic

700    1_

$a Halamek, Josef $u Institute of Scientific Instruments, the Czech Academy of Sciences, Brno, Czech Republic

700    1_

$a Vernooy, Kevin $u Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands

700    1_

$a Smisek, Radovan $u Institute of Scientific Instruments, the Czech Academy of Sciences, Brno, Czech Republic; Brno University of Technology, Faculty of Electrical Engineering and Communication, Department of Biomedical Engineering, Technická 12, Brno, Czech Republic

700    1_

$a Karch, Jakub $u Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic $7 xx0273614

700    1_

$a Plesinger, Filip $u Institute of Scientific Instruments, the Czech Academy of Sciences, Brno, Czech Republic

700    1_

$a Moskal, Pawel $u First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland

700    1_

$a Sušánková, Markéta $u Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic $7 xx0273623

700    1_

$a Znojilová, Lucie $u Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic $7 xx0273622

700    1_

$a Heckman, Luuk $u Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands

700    1_

$a Viscor, Ivo $u Institute of Scientific Instruments, the Czech Academy of Sciences, Brno, Czech Republic

700    1_

$a Vondra, Vlastimil $u Institute of Scientific Instruments, the Czech Academy of Sciences, Brno, Czech Republic

700    1_

$a Leinveber, Pavel $u International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic

700    1_

$a Osmancik, Pavel $u Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic

773    0_

$w MED00156180 $t Heart rhythm $x 1556-3871 $g Roč. 18, č. 8 (2021), s. 1281-1289

856    41

$u https://pubmed.ncbi.nlm.nih.gov/33930549 $y Pubmed

910    __

$a ABA008 $b sig $c sign $y p $z 0

990    __

$a 20220425 $b ABA008

991    __

$a 20220606132337 $b ABA008

999    __

$a ok $b bmc $g 1789762 $s 1163515

BAS    __

$a 3

BAS    __

$a PreBMC

BMC    __

$a 2021 $b 18 $c 8 $d 1281-1289 $e 20210428 $i 1556-3871 $m Heart rhythm $n Heart Rhythm $x MED00156180

LZP    __

$a Pubmed-20220425