Publication detail

Ventricular activation pattern assessment during right ventricular pacing: Ultrahigh-frequency ECG study

ČURILA, K. JURÁK, P. HALÁMEK, J. PRINZEN, F. WALDAUF, P. KARCH, J. ŠTROS, P. PLEŠINGER, F. MIZNER, J. SUŠÁNKOVÁ, M. PROCHÁZKOVÁ, R. SUSSENBEK, O. VIŠČOR, I. VONDRA, V. SMÍŠEK, R. LEINVEBER, P. OSMANČÍK, P.

Original Title

Ventricular activation pattern assessment during right ventricular pacing: Ultrahigh-frequency ECG study

Type

journal article in Web of Science

Language

English

Original Abstract

Background Right ventricular (RV) pacing causes delayed activation of remote ventricular segments. We used the ultrahigh-frequency ECG (UHF-ECG) to describe ventricular depolarization when pacing different RV locations. Methods In 51 patients, temporary pacing was performed at the RV septum (mSp); further subclassified as right ventricular inflow tract (RVIT) and right ventricular outflow tract (RVOT) for septal inflow and outflow positions (below or above the plane of His bundle in right anterior oblique), apex, anterior lateral wall, and at the basal RV septum with nonselective His bundle or RBB capture (nsHBorRBBp). The timings of UHF-ECG electrical activations were quantified as left ventricular lateral wall delay (LVLWd; V8 activation delay) and RV lateral wall delay (RVLWd; V1 activation delay). Results The LVLWd was shortest for nsHBorRBBp (11 ms [95% confidence interval = 5-17]), followed by the RVIT (19 ms [11-26]) and the RVOT (33 ms [27-40]; p < .01 between all of them), although the QRSd for the latter two were the same (153 ms (148-158) vs. 153 ms (148-158); p = .99). RV apical capture not only had a longer LVLWd (34 ms (26-43) compared to mSp (27 ms (20-34), p < .05), but its RVLWd (17 ms (9-25) was also the longest compared to other RV pacing sites (mean values for nsHBorRBBp, mSp, anterior and lateral wall captures being below 6 ms), p < .001 compared to each of them. Conclusion RVIT pacing produces better ventricular synchrony compared to other RV pacing locations with myocardial capture. However, UHF-ECG ventricular dysynchrony seen during RVIT pacing is increased compared to concomitant capture of basal septal myocytes and His bundle or proximal right bundle branch.

Keywords

conductive system; myocardial; pacing; ultra‐ high frequency ECG; ventricular dyssynchrony

Authors

ČURILA, K.; JURÁK, P.; HALÁMEK, J.; PRINZEN, F.; WALDAUF, P.; KARCH, J.; ŠTROS, P.; PLEŠINGER, F.; MIZNER, J.; SUŠÁNKOVÁ, M.; PROCHÁZKOVÁ, R.; SUSSENBEK, O.; VIŠČOR, I.; VONDRA, V.; SMÍŠEK, R.; LEINVEBER, P.; OSMANČÍK, P.

Released

22. 2. 2021

Publisher

WILEY

Location

HOBOKEN

ISBN

1540-8167

Periodical

Journal of Cardiovascular Electrophysiology

Year of study

32

Number

5

State

United States of America

Pages from

1385

Pages to

1394

Pages count

10

URL

https://onlinelibrary.wiley.com/doi/full/10.1111/jce.14985

BibTex

@article{BUT172325,
  author="Karol {Čurila} and Pavel {Jurák} and Josef {Halámek} and Frits {Prinzen} and Petr {Waldauf} and Jakub {Karch} and Petr {Štros} and Filip {Plešinger} and Jan {Mizner} and Markéta {Sušánková} and Radka {Procházková} and Ondřej {Sussenbek} and Ivo {Viščor} and Vlastimil {Vondra} and Radovan {Smíšek} and Pavel {Leinveber} and Pavel {Osmančík}",
  title="Ventricular activation pattern assessment during right ventricular pacing: Ultrahigh-frequency ECG study",
  journal="Journal of Cardiovascular Electrophysiology",
  year="2021",
  volume="32",
  number="5",
  pages="1385--1394",
  doi="10.1111/jce.14985",
  issn="1540-8167",
  url="https://onlinelibrary.wiley.com/doi/full/10.1111/jce.14985"
}