Abstract:
BACKGROUND:Myocardial depolarization can be altered by varying pacing stimulus output. This may have implications on response rates for cardiac resynchronization therapy (CRT). The purpose of our study was to determine the relationship of left ventricular (LV) pacing stimulus intensity to measures of depolarization and repolarization in humans with CRT devices. METHODS:In 37 patients with a CRT device and bipolar LV leads, bipolar LV-only pacing from maximum output to threshold was performed. The presence of changes in depolarization was defined by predetermined changes in ECG morphology that accompanied a change in bipolar stimulus amplitude. ECG parameters and the EGMs were analyzed at various LV pacing stimulus intensities. RESULTS:Changes in ECG morphology were apparent in 70% of patients. These occurred at a mean LV stimulus amplitude of greater than 2.7 +/- 0.8 V at 1 ms. Of the patients with changes in surface ECG, the transventricular conduction time decreased from 155 +/- 41 ms at low output to 141 +/- 39 ms at high output (P < 0.01). Despite a significant reduction in QRS duration with high output, mean QTc and JTc interval increased with increasing LV stimulus strength (539 +/- 45 vs 559 +/- 46 ms (P < 0.01) and 353 +/- 31 ms vs 377 +/- 32 (P < 0.01)). CONCLUSION:Increased LV stimulus intensity, independent of RV anodal capture, is associated with faster transventricular conduction time, changes in myocardial depolarization, and longer QT intervals. These findings have important implications on the relationship of programmed LV pacing output to pacing-induced proarrhythmia and clinical CRT response rates.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Theis C,Bavikati VV,Langberg JJ,Lloyd MSdoi
10.1111/j.1540-8167.2008.01378.xsubject
Has Abstractpub_date
2009-06-01 00:00:00pages
645-9issue
6eissn
1045-3873issn
1540-8167pii
JCE1378journal_volume
20pub_type
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1046/j.1540-8167.2004.03488.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,meta分析,评审
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更新日期:2016-12-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1111/j.1540-8167.2009.01480.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00713.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00965.x
更新日期:2001-08-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
doi:10.1111/j.1540-8167.1995.tb00378.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb01003.x
更新日期:1997-10-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1111/j.1540-8167.2011.02206.x
更新日期:2012-02-01 00:00:00
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更新日期:2020-03-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-02-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.04428.x
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更新日期:2019-12-01 00:00:00
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doi:10.1111/j.1540-8167.1999.tb00282.x
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pub_type: 杂志文章,评审
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更新日期:2002-04-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01210.x
更新日期:2008-10-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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pub_type: 临床试验,杂志文章
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更新日期:2004-08-01 00:00:00
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更新日期:2017-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-11-01 00:00:00
abstract:INTRODUCTION:Right ventricular outflow tract ventricular arrhythmias (RVOT VAs) often originate in the voltage-transitional zone. The target electrogram could be compromised by the architecture of the roving catheter. Mini-electrodes could improve the mapping resolution, especially in low-voltage areas. The aim was to ...
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更新日期:2019-05-01 00:00:00