českyenglish

4202011_email_gmail_mail_logo_social_icon.png  4102573_applications_facebook_media_social_icon.png  11244080_x_twitter_elon_musk_twitter_new_logo_icon.png  5296501_linkedin_network_linkedin_logo_icon.png  386762_youtube_video_you_tube_icon.png

PROHLÍŽENÍ ABSTRAKTA

CONDUCTION SYSTEM PACING PRESERVES BOTH ELECTRICAL AND MECHANICAL INTERVENTRICULAR SYNCHRONY – A UHF-ECG VALIDATION STUDY (YOUNG INVESTIGATOR AWARD COMPETITION)
Tématický okruh: Kardiostimulátory
Typ: Ústní sdělení - lékařské , Číslo v programu: 11
Přihlášeno do: Soutěž mladých kardiologů
Mizner J.1, Jurák P.2, Línková H.1, Štros P.1, Süssenbek O.1, Veselá J.1, Beela A.3, Lumens J.3, Čurila K.1

1 Kardiologická klinika 3. lékařské fakulty Univerzity Karlovy, Fakultní nemocnice Královské Vinohrady, Praha, 2 Ústav přístrojové techniky, Akademie věd České republiky, Brno, 3 Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, Netherlands


Background:
Interventricular mechanical delay (IVMD) is an established echocardiographic risk factor for pacing-induced cardiomyopathy development. Ultra-high-frequency ECG (UHF-ECG) is a non-invasive tool visualizing the ventricular activation sequence.

Aims:
To compare UHF-ECG interventricular dyssynchrony with echocardiography and to establish interventricular dyssynchrony related to conductive system pacing (CSP) and right ventricular pacing (RVP).

Methods:
54 patients with advanced AV conduction disease, without organic heart disease, and preserved LV systolic function were prospectively included. Thirty-three had RVP, and twenty-one had CSP. CSP included both His bundle pacing (n=5) and left bundle branch area pacing (n=16). UHF-ECG and echocardiography were obtained at the baseline and after 1 year of pacing. IVMD was manually calculated from standard echocardiographic projections. E-DYSV8-V1 was automatically calculated as a time difference between activation in V8 (LV free wall) and V1 electrode (RV free wall).

Results
Both groups had similar baseline clinical characteristics and similar preimplant IVMD and e-DYSV8-V1. While interventricular dyssynchrony was not changed during CSP (mean change -0.37 ± 4.8ms, p=0.94 for IVMD and -1.7 ± 3.7ms, p=0.98 for e-DYSV8 -V1), it was significantly increased with RVP (mean change +29.3 ± 4.6 ms, p0.0001 for IVMD and +26.1 ± 5.1 ms, p=0.0001 for e-DYSV8-V1). There was a strong overall correlation between IVMD and e-DYSV8 -V1 in all studied ventricular rhythms (R=0.73, p=0.0001) - Figure.

Conclusions
UHF-ECG expresses the interventricular dyssynchrony noninvasively by measuring the activation difference between V8-V1 chest leads. RV myocardial pacing increases interventricular dyssynchrony, while CSP doesn’t.