PO-03-109 RIGHT VENTRICULAR PACING EXACERBATE ELECTRICAL DYSSYNCHRONY BEYOND INTRINSIC LEFT BUNDLE BRANCH BLOCK
نویسندگان
چکیده
Right ventricular (RV) pacing produces an iatrogenic form of left bundle branch block (LBBB). Intrinsic LBBB (I-LBBB) can cause adverse hemodynamic effects due to dyssynchrony, mainly in patients with heart failure and reduced ejection fraction (HFrEF). Although RV is thought create a similar activation pattern as LBBB, some studies suggest apical be harmful even I-LBBB. Currently, the mechanism responsible for this harm not fully understood. We aimed quantify compare degree electrical measured on surface ECG, during I-LBBB, HFrEF (left EF ≤40%) Patients prophylactic defibrillator therapy were prospectively recruited. For each patient, 3-minute, high-resolution (1024 Hz), digital 12-lead ECGs recorded I-LBBB rhythm then at 60 bpm or intrinsic rate (whichever was higher). High-resolution analyzed abnormal intra-QRS peaks (QRSp) measure dyssynchrony. QRSp defined mean number detected QRS complex that deviated from smoothing-filtered version QRS. automatically quantified precordial lead using validated custom software. Mean average leads. Thirty (66±9 yrs, 50% male, LVEF 30±8%) (QRS duration [QRSd]: 172±22 ms) included. Changes between are shown (Figure1A). increased 27 (90%) compared suggesting overall more dyssynchrony pacing. QRSd (Figure 1B). resulted widening beyond 18 (60%), while did change remaining patients. During (versus I-LBBB), changed (27 versus patients; p = 0.007). dyssynchronous by changes QRSd. Compared QRSd, sensitive marker Our results exacerbate those
منابع مشابه
Differing effects of right ventricular pacing and left bundle branch block on left ventricular function.
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ژورنال
عنوان ژورنال: Heart Rhythm
سال: 2023
ISSN: ['1556-3871', '1547-5271']
DOI: https://doi.org/10.1016/j.hrthm.2023.03.1083