000129822 001__ 129822
000129822 005__ 20241125101147.0
000129822 0247_ $$2doi$$a10.1093/europace/euad122.384
000129822 0248_ $$2sideral$$a136107
000129822 037__ $$aART-2023-136107
000129822 041__ $$aeng
000129822 100__ $$aSales Belles, C$$uUniversidad de Zaragoza
000129822 245__ $$aCharacterization of the effects of right ventricular and left bundle branch area pacing on the QRS complex
000129822 260__ $$c2023
000129822 5060_ $$aAccess copy available to the general public$$fUnrestricted
000129822 5203_ $$aIntroduction: Right ventricular pacing (RVP) has been the treatment of choice for patients with atrioventricular block and sinus node disease for the last decades . It is well known that RVP ventricular may cause ventricular dyssynchrony and could lead to left ventricular dysfunction in 20% of patients, and therefore could increase the risk of heart failure, atrial fibrillation and cardiovascular mortality. Left bundle branch area pacing (LBBAP) has recently emerged as a new physiological pacing modality that can circumvent the limitations of RVP. The purpose of this study was to compare changes induced by RVP and LBBAP in the standard 12-lead ECG by the analysis of QRS complex characteristics in order to asses ventricular dyssynchrony.
Methods: ECG recordings from 134 patients (82 LBBAP, 52 RVP) with indication for anti-bradycardia therapy were acquired before and after pacemaker implantation. Patients were grouped into narrow and wide baseline QRS using a threshold for the QRS duration of 120 ms. Median beats were calculated at baseline and 24 hours post-implantation states for each patient. ECG markers describing ventricular activation were measured, including: 1) QRS duration (QRSd) from QRS onset to QRS end; 2) QRS area (QRSa), computed from the individual areas in orthogonal X, Y and Z leads calculated using the Kors conversion matrix; 3) a new index QRS50 proposed to estimate the ventricular activation time from the first three components of the singular value decomposition of the median QRS complex.
Results: Note that the QRS characteristics showed similar values in baseline for both pacing techniques. In patients with narrow QRS, we found that paced QRS characteristics remained similar from the basal QRS in LBBAP group whereas in RVP group they worsened. The three markers, QRSd, QRSa and QRS50, increased after RVP by 34 ms, 68 uVs and 22 ms, respectively (p<0,001). In patients with wide QRS, LBBAP significantly reduced QRSd, QRSa and QRS50 while RVP increased QRSa and QRS50 and left QRSd unchanged.
Conclusion: In patients receiving a pacemaker for anti-bradycardia therapy, LBBAP led to more synchronized ventricular activation than RVP measured from QRS duration- and area-related characteristics.
000129822 536__ $$9info:eu-repo/grantAgreement/ES/DGA/LMP94_21$$9info:eu-repo/grantAgreement/EUR/MICINN/TED2021-130459B-I00
000129822 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000129822 590__ $$a7.9$$b2023
000129822 592__ $$a2.895$$b2023
000129822 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b19 / 222 = 0.086$$c2023$$dQ1$$eT1
000129822 593__ $$aPhysiology (medical)$$c2023$$dQ1
000129822 593__ $$aCardiology and Cardiovascular Medicine$$c2023$$dQ1
000129822 594__ $$a10.3$$b2023
000129822 655_4 $$ainfo:eu-repo/semantics/conferenceObject$$vinfo:eu-repo/semantics/publishedVersion
000129822 700__ $$aMelero Polo, J
000129822 700__ $$aCabrera Ramos, M
000129822 700__ $$aVadillo Martin, P
000129822 700__ $$aMayo Carlos, V
000129822 700__ $$0(orcid)0000-0001-5935-9454$$aPalacios Rosales, S$$uUniversidad de Zaragoza
000129822 700__ $$0(orcid)0000-0002-7503-3339$$aMartinez Cortes, J P$$uUniversidad de Zaragoza
000129822 700__ $$0(orcid)0000-0003-3183-4107$$aMinchole Lapuente, A$$uUniversidad de Zaragoza
000129822 700__ $$0(orcid)0000-0002-1960-407X$$aPueyo Paules, E$$uUniversidad de Zaragoza
000129822 700__ $$aRamos Maqueda, J$$uUniversidad de Zaragoza
000129822 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000129822 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000129822 773__ $$g25, Suppl. 1 (2023)$$pEuropace$$tEuropace$$x1099-5129
000129822 8564_ $$s208064$$uhttps://zaguan.unizar.es/record/129822/files/texto_completo.pdf$$yVersión publicada
000129822 8564_ $$s1662817$$uhttps://zaguan.unizar.es/record/129822/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000129822 909CO $$ooai:zaguan.unizar.es:129822$$particulos$$pdriver
000129822 951__ $$a2024-11-22-12:04:57
000129822 980__ $$aARTICLE