Simple electrophysiological predictor of QRS change induced by cardiac resynchronization therapy: A novel marker of complete left bundle branch block
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
34098086
DOI
10.1016/j.hrthm.2021.05.033
PII: S1547-5271(21)00539-7
Knihovny.cz E-zdroje
- Klíčová slova
- Cardiac resynchronization therapy, Electrocardiography, Heart failure, Left bundle branch block, Outcome predictors,
- MeSH
- blokáda Tawarova raménka diagnóza patofyziologie terapie MeSH
- elektrofyziologické techniky kardiologické metody MeSH
- funkce levé komory srdeční fyziologie MeSH
- lidé MeSH
- následné studie MeSH
- prediktivní hodnota testů MeSH
- převodní systém srdeční patofyziologie MeSH
- prospektivní studie MeSH
- senioři MeSH
- srdeční komory patofyziologie MeSH
- srdeční resynchronizační terapie metody MeSH
- tepový objem fyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: QRS complex shortening by cardiac resynchronization therapy (CRT) has been associated with improved outcomes. OBJECTIVE: We hypothesized that the absence of QRS duration (QRSd) prolongation by right ventricular mid-septal pacing (RVP) may indicate complete left bundle branch block (cLBBB). METHODS: We prospectively collected 12-lead surface electrocardiograms (ECGs) and intracardiac electrograms during CRT implant procedures. Digital recordings were edited and manually measured. The outcome measure was a change in QRSd induced by CRT (delta CRT). Several outcome predictors were investigated: native QRSd, cLBBB (by using Strauss criteria), interval between the onset of the QRS complex and the local left ventricular electrogram (Q-LV), and a newly proposed index defined by the difference between RVP and native QRSd (delta RVP). RESULTS: One hundred thirty-three consecutive patients were included in the study. Delta RVP was 27 ± 25 ms, and delta CRT was -14 ± 28 ms. Delta CRT correlated with native QRSd (r = -0.65), with the presence of ECG-based cLBBB (r = -0.40), with Q-LV (r = -0.68), and with delta RVP (r = 0.72) (P < .00001 for all correlations). In multivariable analysis, delta CRT was most strongly associated with delta RVP (P < .00001), followed by native QRSd and Q-LV, while ECG-based cLBBB became a nonsignificant factor. CONCLUSION: Baseline QRSd, delta RVP, and LV electrical lead position (Q-LV) represent strong independent predictors of ECG response to CRT. The absence of QRSd prolongation by RVP may serve as an alternative and more specific marker of cLBBB. Delta RVP correlates strongly with the CRT effect on QRSd and outperforms the predictive value of ECG-based cLBBB.
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiovascular Sciences Policlinico Casilino of Rome Rome Italy
Citace poskytuje Crossref.org
Is it a true left bundle branch block or not?
