Comparing Ventricular Synchrony in Left Bundle Branch and Left Ventricular Septal Pacing in Pacemaker Patients

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dc.contributor.authorHeckman, Luukcs
dc.contributor.authorLuermans, Justincs
dc.contributor.authorČurila, Karolcs
dc.contributor.authorVan Stipdonk, Antoniuscs
dc.contributor.authorWestra, Sjoerdcs
dc.contributor.authorSmíšek, Radovancs
dc.contributor.authorPrinzen, Fritscs
dc.contributor.authorVernooy, Kevincs
dc.coverage.issue4cs
dc.coverage.volume10cs
dc.date.accessioned2021-11-12T22:56:35Z
dc.date.available2021-11-12T22:56:35Z
dc.date.issued2021-03-17cs
dc.description.abstractBackground: Left bundle branch area pacing (LBBAP) has recently been introduced as a novel physiological pacing strategy. Within LBBAP, distinction is made between left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP, no left bundle capture). Objective: To investigate acute electrophysiological effects of LBBP and LVSP as compared to intrinsic ventricular conduction. Methods: Fifty patients with normal cardiac function and pacemaker indication for bradycardia underwent LBBAP. Electrocardiography (ECG) characteristics were evaluated during pacing at various depths within the septum: starting at the right ventricular (RV) side of the septum: the last position with QS morphology, the first position with r' morphology, LVSP and-in patients where left bundle branch (LBB) capture was achieved-LBBP. From the ECG's QRS duration and QRS morphology in lead V1, the stimulus- left ventricular activation time left ventricular activation time (LVAT) interval were measured. After conversion of the ECG into vectorcardiogram (VCG) (Kors conversion matrix), QRS area and QRS vector in transverse plane (Azimuth) were determined. Results: QRS area significantly decreased from 82 +/- 29 mu Vs during RV septal pacing (RVSP) to 46 +/- 12 mu Vs during LVSP. In the subgroup where LBB capture was achieved (n = 31), QRS area significantly decreased from 46 +/- 17 mu Vs during LVSP to 38 +/- 15 mu Vs during LBBP, while LVAT was not significantly different between LVSP and LBBP. In patients with normal ventricular activation and narrow QRS, QRS area during LBBP was not significantly different from that during intrinsic activation (37 +/- 16 vs. 35 +/- 19 mu Vs, respectively). The Azimuth significantly changed from RVSP (-46 +/- 33 degrees) to LVSP (19 +/- 16 degrees) and LBBP (-22 +/- 14 degrees). The Azimuth during both LVSP and LBBP were not significantly different from normal ventricular activation. QRS area and LVAT correlated moderately (Spearman's R = 0.58). Conclusions: ECG and VCG indices demonstrate that both LVSP and LBBP improve ventricular dyssynchrony considerably as compared to RVSP, to values close to normal ventricular activation. LBBP seems to result in a small, but significant, improvement in ventricular synchrony as compared to LVSP.en
dc.formattextcs
dc.format.extent1-12cs
dc.format.mimetypeapplication/pdfcs
dc.identifier.citationJournal of Clinical Medicine. 2021, vol. 10, issue 4, p. 1-12.en
dc.identifier.doi10.3390/jcm10040822cs
dc.identifier.issn2077-0383cs
dc.identifier.other172323cs
dc.identifier.urihttp://hdl.handle.net/11012/202248
dc.language.isoencs
dc.publisherMDPIcs
dc.relation.ispartofJournal of Clinical Medicinecs
dc.relation.urihttps://pubmed.ncbi.nlm.nih.gov/33671420/cs
dc.rightsCreative Commons Attribution 4.0 Internationalcs
dc.rights.accessopenAccesscs
dc.rights.sherpahttp://www.sherpa.ac.uk/romeo/issn/2077-0383/cs
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/cs
dc.subjectleft bundle branch area pacingen
dc.subjectbradycardia pacingen
dc.subjectcardiac resynchronization therapyen
dc.titleComparing Ventricular Synchrony in Left Bundle Branch and Left Ventricular Septal Pacing in Pacemaker Patientsen
dc.type.driverarticleen
dc.type.statusPeer-revieweden
dc.type.versionpublishedVersionen
sync.item.dbidVAV-172323en
sync.item.dbtypeVAVen
sync.item.insts2021.11.25 20:54:16en
sync.item.modts2021.11.25 20:15:20en
thesis.grantorVysoké učení technické v Brně. Fakulta elektrotechniky a komunikačních technologií. Ústav biomedicínského inženýrstvícs
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