000160847 001__ 160847
000160847 005__ 20251017144550.0
000160847 0247_ $$2doi$$a10.1038/s41598-025-98608-6
000160847 0248_ $$2sideral$$a144059
000160847 037__ $$aART-2025-144059
000160847 041__ $$aeng
000160847 100__ $$aSales-Belles, Clara$$uUniversidad de Zaragoza
000160847 245__ $$aECG-based evaluation of ventricular synchrony in left bundle branch area pacing through characterization of the activation sequence
000160847 260__ $$c2025
000160847 5060_ $$aAccess copy available to the general public$$fUnrestricted
000160847 5203_ $$aLeft bundle branch area pacing (LBBAP) overcomes ventricular dyssynchrony induced by conventional right ventricular pacing (RVP). Despite QRS duration (QRSd) being the standard ECG marker for biventricular synchrony, it lacks insights into the ventricular activation sequence. Our aim is to assess biventricular synchrony by characterizing the ventricular activation sequence and introducing robust markers using the 12-lead ECG. A prospective single-center study was conducted, involving patients with pacemaker indication due to bradycardia. Patients were divided into LBBAP and RVP, and classified by baseline-QRS morphology. To assess biventricular synchrony, low frequency-based QRS analysis was performed to compute the ventricular activation sequence and precordial activation delay (pAD). Additional QRS markers including QRSd, QRS60, and QRS area (QRSa) were calculated. A total of 176 patients (107 LBBAP, 69 RVP) were included. The paced ventricular activation sequence indicated a more physiological pattern after LBBAP than RVP, with lower pAD values in narrow QRS, RBBB, and LBBB subgroups [ − 10( − 20,14) vs. 26(5, 39) ms; − 18( − 30, − 8) vs. 34(26, 55) ms; 10( − 14, 25) vs. 32(12, 48) ms] (p < 0.01). In all subgroups, QRS60 showed lower values after LBBAP than RVP [52(41, 62) vs.73(65, 80) ms; 60(55, 66) vs. 77(67, 83) ms; 59(53, 64) vs. 77(74, 82) ms] (p < 0.01) and QRSa were also lower [53(38, 66) vs. 121(92, 143) μVs; 60(50, 89) vs. 124(97, 159) μVs; 62(52, 80) vs. 133(99, 148) μVs] (p < 0.01). pAD provides valuable insights into ventricular activation beyond paced-QRSd. Together with QRS60 and QRSa, pAD could be a promising tool to assess biventricular synchrony.
000160847 536__ $$9info:eu-repo/grantAgreement/ES/AEI/PID2021-128972OA-I00$$9info:eu-repo/grantAgreement/ES/DGA/LMP94_21$$9info:eu-repo/grantAgreement/ES/DGA/T39-23R$$9info:eu-repo/grantAgreement/ES/MICINN/CNS2022-135899$$9info:eu-repo/grantAgreement/ES/MICINN/PID2022-140556OB-I00$$9info:eu-repo/grantAgreement/ES/MICINN/RYC2019-027420-I$$9info:eu-repo/grantAgreement/EUR/MICINN/TED2021-130459B-I00
000160847 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
000160847 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000160847 700__ $$0(orcid)0000-0003-3183-4107$$aMincholé, Ana$$uUniversidad de Zaragoza
000160847 700__ $$aMelero-Polo, Jorge
000160847 700__ $$aCabrera-Ramos, Mercedes$$uUniversidad de Zaragoza
000160847 700__ $$aVadillo-Martín, Pablo
000160847 700__ $$aMontilla-Padilla, Isabel$$uUniversidad de Zaragoza
000160847 700__ $$aSorinas-Villanueva, Laura
000160847 700__ $$aJulián-García, Inés
000160847 700__ $$aMayo-Carlos, Gualber Vitto
000160847 700__ $$aRuiz-Arroyo, José Ramón
000160847 700__ $$0(orcid)0000-0002-1960-407X$$aPueyo, Esther$$uUniversidad de Zaragoza
000160847 700__ $$aRamos-Maqueda, Javier$$uUniversidad de Zaragoza
000160847 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000160847 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000160847 773__ $$g15 (2025), 15584 [12 pp.]$$pSci. rep. (Nat. Publ. Group)$$tScientific reports (Nature Publishing Group)$$x2045-2322
000160847 8564_ $$s2289528$$uhttps://zaguan.unizar.es/record/160847/files/texto_completo.pdf$$yVersión publicada
000160847 8564_ $$s2360023$$uhttps://zaguan.unizar.es/record/160847/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000160847 909CO $$ooai:zaguan.unizar.es:160847$$particulos$$pdriver
000160847 951__ $$a2025-10-17-14:11:36
000160847 980__ $$aARTICLE