期刊
HEART RHYTHM
卷 19, 期 12, 页码 1984-1992出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2022.07.022
关键词
Left bundle branch pacing; Left bundle branch capture; Left ventricular septal pacing; His bundle pacing; Right ventricular septal pacing
资金
- National Natural Science Foundation of China [82070521]
- Clinical Competence Improvement Project of Jiangsu Province Hospital [JSPH-MA-2020-3]
- Project on New Technology of Jiangsu Province [JX233C202103]
The study aimed to develop a new personalized intraoperative criterion to confirm left bundle branch capture in patients with or without heart failure, which is of great significance.
BACKGROUND Left bundle branch pacing (LBBP) is an emerging physiological pacing modality. How to differentiate LBBP from left ventricular septal pacing (LVSP) remains challenging. OBJECTIVE We aimed to develop a new personalized intraoperative criterion to confirm left bundle branch (LBB) capture in patients with or without heart failure (HF). METHODS Patients were enrolled if 12-lead surface electrocardiograms of LBBP, LVSP, temporary His bundle pacing (HBP), and right ventricular septal pacing (RVSP) were recorded during the procedure, with the leads placed in the basal midseptal region. Left ventricular activation time (LVAT) was measured during different pacing modalities. Delta LVAT1 was defined as the difference in LVAT between HBP and LBBP/LVSP. Delta LVAT2 was estimated by the difference in LVAT between RVSP and LBBP/LVSP. Delta LVAT1% and Delta LVAT2% were calculated as the percent reduction of Delta LVAT1 and Delta LVAT2, respectively. RESULTS A total of 105 consecutive patients were included, of whom 80 (76.2%) had normal cardiac function (65 LBBP and 15 LVSP) and 25 had HF. Patients with LBBP showed significantly shorter LVAT than did those with LVSP. In patients with normal cardiac function, a cutoff value of Delta LVAT1 > 12.5 ms showed 73.9% sensitivity and 93.3% specificity to confirm LBB capture. In patients with HF, a cutoff value of Delta LVAT1% > 9.8% exhibited great accuracy for LBB capture (sensitivity 92.0%; specificity 92.3%). The optimal value of Delta LVAT2% for differentiating LBBP from LVSP was 21.2%. CONCLUSION Temporary HBP and RVSP can serve as references to confirm LBB capture in an individualized fashion in patients with or without HF.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据