Bipolar anodal septal pacing with direct LBB capture preserves physiological ventricular activation better than unipolar left bundle branch pacing

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dc.contributor.authorČurila, Karolcs
dc.contributor.authorJurák, Pavelcs
dc.contributor.authorPrinzen, Fritscs
dc.contributor.authorJastrzebski, Marekcs
dc.contributor.authorWaldauf, Petrcs
dc.contributor.authorHalámek, Josefcs
dc.contributor.authorTóthová, Markétacs
dc.contributor.authorZnojilová, Luciecs
dc.contributor.authorSmíšek, Radovancs
dc.contributor.authorKach, Jakubcs
dc.contributor.authorPovišer, Lukášcs
dc.contributor.authorLinková, Hanacs
dc.contributor.authorPlešinger, Filipcs
dc.contributor.authorMoskal, Pawelcs
dc.contributor.authorViščor, Ivocs
dc.contributor.authorVondra, Vlastimilcs
dc.contributor.authorLeinveber, Pavelcs
dc.contributor.authorOsmančík, Pavelcs
dc.coverage.issue1cs
dc.coverage.volume10cs
dc.date.issued2023-03-22cs
dc.description.abstractBackgroundLeft bundle branch pacing (LBBP) produces delayed, unphysiological activation of the right ventricle. Using ultra-high-frequency electrocardiography (UHF-ECG), we explored how bipolar anodal septal pacing with direct LBB capture (aLBBP) affects the resultant ventricular depolarization pattern. MethodsIn patients with bradycardia, His bundle pacing (HBP), unipolar nonselective LBBP (nsLBBP), aLBBP, and right ventricular septal pacing (RVSP) were performed. Timing of local ventricular activation, in leads V1-V8, was displayed using UHF-ECG, and electrical dyssynchrony (e-DYS) was calculated as the difference between the first and last activation. Durations of local depolarizations were determined as the width of the UHF-QRS complex at 50% of its amplitude. ResultsaLBBP was feasible in 63 of 75 consecutive patients with successful nsLBBP. aLBBP significantly improved ventricular dyssynchrony (mean -9 ms; 95% CI (-12;-6) vs. -24 ms (-27;-21), ), p < 0.001) and shortened local depolarization durations in V1-V4 (mean differences -7 ms to -5 ms (-11;-1), p < 0.05) compared to nsLBBP. aLBBP resulted in e-DYS -9 ms (-12; -6) vs. e-DYS 10 ms (7;14), p < 0.001 during HBP. Local depolarization durations in V1-V2 during aLBBP were longer than HBP (differences 5-9 ms (1;14), p < 0.05, with local depolarization duration in V1 during aLBBP being the same as during RVSP (difference 2 ms (-2;6), p = 0.52). ConclusionAlthough aLBBP improved ventricular synchrony and depolarization duration of the septum and RV compared to unipolar nsLBBP, the resultant ventricular depolarization was still less physiological than during HBP.en
dc.formattextcs
dc.format.extent1-9cs
dc.format.mimetypeapplication/pdfcs
dc.identifier.citationFrontiers in Cardiovascular Medicine. 2023, vol. 10, issue 1, p. 1-9.en
dc.identifier.doi10.3389/fcvm.2023.1140988cs
dc.identifier.issn2297-055Xcs
dc.identifier.orcid0000-0003-0413-3604cs
dc.identifier.orcid0000-0001-7267-4408cs
dc.identifier.other183301cs
dc.identifier.researcheridF-5329-2017cs
dc.identifier.scopus57188873046cs
dc.identifier.urihttp://hdl.handle.net/11012/213624
dc.language.isoencs
dc.publisherFrontierscs
dc.relation.ispartofFrontiers in Cardiovascular Medicinecs
dc.relation.urihttps://www.frontiersin.org/articles/10.3389/fcvm.2023.1140988/fullcs
dc.rightsCreative Commons Attribution 4.0 Internationalcs
dc.rights.accessopenAccesscs
dc.rights.sherpahttp://www.sherpa.ac.uk/romeo/issn/2297-055X/cs
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/cs
dc.subjectUltra-high-frequency ECGen
dc.subjectdyssynchronyen
dc.subjectLBBPen
dc.subjectanodal septal pacingen
dc.subjectHis bundle pacingen
dc.titleBipolar anodal septal pacing with direct LBB capture preserves physiological ventricular activation better than unipolar left bundle branch pacingen
dc.type.driverarticleen
dc.type.statusPeer-revieweden
dc.type.versionpublishedVersionen
sync.item.dbidVAV-183301en
sync.item.dbtypeVAVen
sync.item.insts2025.02.03 15:39:56en
sync.item.modts2025.01.17 19:33:55en
thesis.grantorVysoké učení technické v Brně. Fakulta elektrotechniky a komunikačních technologií. Ústav biomedicínského inženýrstvícs
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