Relationship Between Electrical Parameters and Cardiac Synchrony in Patients Underwent Left Bundle Branch Area Pacing.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Pace-Pacing and Clinical Electrophysiology Pub Date : 2024-10-22 DOI:10.1111/pace.15095

Manxin Lin, Shufen Huang, Xinyi Huang, Jincun Guo, Linlin Li, Simei Chen, Guiyang Li, Qiang Li, Dong Chang, Maolong Su, Binni Cai

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引用次数: 0

Abstract

Purpose: The study aims to assess cardiac synchrony under different left bundle branch area pacing (LBBAP) and evaluate the relationship between different surface or intracardiac electrical parameters and mechanical synchrony.

Methods: Eighty-two patients with successful LBBAP were recruited. The electrical synchrony, evaluated by paced QRS duration (pQRSD) and Stim-LVAT (stimulus to left ventricular activation time), and mechanical synchrony, evaluated by the standard deviation of the time-to-peak contraction velocity in 12 left ventricular segments (Tsd-12-LV), were compared between groups in patients underwent LBBAP. To investigate the relationship between different electrical parameters with mechanical synchrony under LBBAP, patients were divided into subgroups according to left ventricular activation time (LVAT, < 60, 60-70, and > 70 ms), presence of left bundle branch (LBB) potential (positive, negative), QRS axis (normal, left axis deviation [LAD]), and potential to ventricular interval (PVI, < 20 and > 20 ms). Mechanical synchrony was compared among the subgroups respectively 3 days post LBBAP procedure.

Results: No statistically significant differences were documented in electrical synchrony, evaluated by pQRSD, and mechanical synchrony, evaluated by Tsd-12-LV among the subgroups divided by the stim-LVAT, LBB potential, PVI duration, or paced QRS axis in the LBBAP group.

Conclusions: LBB potential, PVI, or normal paced QRS axis is not the prerequisite for successful LBBAP and optimal cardiac synchrony. Adopting a Stim-LVAT value of less than 75 ms to attain ideal electrical and mechanical synchrony during the LBBAP procedure may be applicable.

Trial registration: http://www.chictr.org.cn/index.aspx.

Clinicaltrials: gov identifier: ChiCTR1800021104.

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左束支区起搏患者的电参数与心脏同步性之间的关系

目的：该研究旨在评估不同左束支区起搏（LBBAP）下的心脏同步性，并评估不同体表或心内电参数与机械同步性之间的关系：招募了82名成功进行左束支区域起搏的患者。通过起搏QRS持续时间（pQRSD）和刺激到左心室激活时间（Stim-LVAT）评估电同步性，通过12个左心室节段的时间到峰值收缩速度的标准偏差（Tsd-12-LV）评估机械同步性。为了研究 LBBAP 条件下不同电参数与机械同步性之间的关系，研究人员根据左室激活时间（LVAT，< 60、60-70 和 > 70 毫秒）、左束支电位（LBB）（正、负）、QRS 轴（正常、左轴偏离 [LAD]）和电位至心室间期（PVI，< 20 和 > 20 毫秒）将患者分为不同的亚组。分别比较了 LBBAP 术后 3 天各分组的机械同步性：结果：根据刺激-LVAT、LBB电位、PVI持续时间或LBBAP组起搏QRS轴划分的亚组之间，用pQRSD评估的电同步性和用Tsd-12-LV评估的机械同步性均无统计学差异：LBB电位、PVI或正常起搏QRS轴并不是LBBAP成功和最佳心脏同步的先决条件。在 LBBAP 过程中，采用小于 75 毫秒的 Stim-LVAT 值来实现理想的电气和机械同步可能是适用的。试验注册：http://www.chictr.org.cn/index.aspx.Clinicaltrials: gov identifier：ChiCTR1800021104。

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来源期刊

Pace-Pacing and Clinical Electrophysiology 医学-工程：生物医学

CiteScore

2.70

自引率

5.60%

发文量

209

审稿时长

2-4 weeks

期刊介绍： Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.