Depolarization-repolarization synchrony after right ventricular and left bundle branch area pacing Article Swipe
Claire Belles
,
Jorge Melero Polo
,
M Cabrera Ramos
,
Ana Mincholé Lapuente
,
E Pueyo Paules
,
Javier Ramos Maqueda
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/europace/euad122.382
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/europace/euad122.382
Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): TED2021-130459B-I00 LMP94_21 Introduction Left bundle branch area pacing (LBBAP) has been recently proposed to overcome the limitations associated with right ventricular pacing (RVP) and has been suggested as a new physiological pacing form with high feasibility and safety. A greater difference between QRS complex and T-wave angle directions has been proposed as a marker of abnormal electrical activity in several patient populations, but a comparison between these two pacing modalities has never been performed. The total cosine R to T (TCRT) is an ECG descriptor that accounts for depolarization-repolarization synchrony by measuring the difference between their directions. The purpose of this study was to compare TCRT in patients referred for RVP and LBBAP pacing as anti-bradycardia therapy. Methods ECG recordings from 134 patients (82 LBBAP, 52 RVP) were classified into two groups, narrow QRS and wide QRS, depending on the patient’s QRS duration prior to implantation. In the post-implantation state, the TCRT index was calculated from a median beat calculated for each patient. Singular value decomposition was applied to the median beat in the eight independent ECG leads (I, II, V1, V2, V3, V4, V5, V6). The QRS complex and T wave loops in a three-dimensional space were determined from the first three components of the decomposition. TCRT was computed as the average of the cosines of the angles between the QRS complex directions and the maximum T wave direction. More positive values corresponded to more synchronized depolarization and repolarization processes while more negative values indicated larger differences in the orientation of the QRS and T wave loops and, therefore, greater dyssynchronization. Results showed that TCRT took negative values for both techniques, RVP and LBBAP, and both groups, narrow and wide QRS, indicating that pacing generated dyssynchronization between ventricular depolarization and repolarization. Nevertheless, TCRT values for both groups were significantly more negative (p<0.01) for RVP than for LBBAP. We hypothesize that cardiac memory induced by pacing could account for these negative TCRT values. In any case, LBBAP did not increase the difference in the QRS complex and T wave loop orientations as much as RVP. Conclusion LBBAP induces less dyssynchrony than RVP in the depolarization-repolarization process.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/europace/euad122.382
- https://academic.oup.com/europace/article-pdf/25/Supplement_1/euad122.382/50427713/euad122.382.pdf
- OA Status
- hybrid
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4377984310
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4377984310Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/europace/euad122.382Digital Object Identifier
- Title
-
Depolarization-repolarization synchrony after right ventricular and left bundle branch area pacingWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-05-24Full publication date if available
- Authors
-
Claire Belles, Jorge Melero Polo, M Cabrera Ramos, Ana Mincholé Lapuente, E Pueyo Paules, Javier Ramos MaquedaList of authors in order
- Landing page
-
https://doi.org/10.1093/europace/euad122.382Publisher landing page
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https://academic.oup.com/europace/article-pdf/25/Supplement_1/euad122.382/50427713/euad122.382.pdfDirect link to full text PDF
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YesWhether a free full text is available
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hybridOpen access status per OpenAlex
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https://academic.oup.com/europace/article-pdf/25/Supplement_1/euad122.382/50427713/euad122.382.pdfDirect OA link when available
- Concepts
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QRS complex, Medicine, Repolarization, Cardiology, Bradycardia, Internal medicine, Electrocardiography, Bundle branch block, Beat (acoustics), Electrophysiology, Heart rate, Physics, Acoustics, Blood pressureTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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