Abstract:
BACKGROUND:Right ventricular myocardial pacing leads to nonphysiological activation of heart ventricles. Contrary to this, His bundle pacing preserves their fast activation. Ultra-high-frequency electrocardiography (UHF-ECG) is a novel tool for ventricular depolarization assessment. OBJECTIVE:The purpose of this study was to describe UHF-ECG depolarization patterns during myocardial and His bundle pacing. METHODS:Forty-six patients undergoing His bundle pacing to treat bradycardia and spontaneous QRS complexes without bundle branch block were included. UHF-ECG recordings were performed during spontaneous rhythm, pure myocardial para-Hisian capture, and His bundle capture. QRS duration, QRS area, depolarization time in specific leads, and the UHF-ECG-derived ventricular dyssynchrony index were calculated. RESULTS:One hundred thirty-three UHF-ECG recordings were performed in 46 patients (44 spontaneous rhythm, 28 selective His bundle, 43 nonselective His bundle, and 18 myocardial capture). The mean QRS duration was 117 ms for spontaneous rhythm, 118 ms for selective, 135 ms for nonselective, and 166 ms for myocardial capture (P < .001 for nonselective and myocardial capture compared to each of the other types of ventricular activation). The calculated dyssynchrony index was shortest during spontaneous rhythm (12 ms; P = .02 compared to selective and P = .09 compared to nonselective), and it did not differ between selective and nonselective His bundle capture (16 vs 15 ms; P > .99) and was longest during myocardial capture of the para-Hisian area (37 ms; P < .001 compared to each of the other types of ventricular activation). CONCLUSION:In patients without bundle branch block, both types of His bundle, but not myocardial, capture preserve ventricular electrical synchrony as measured using UHF-ECG.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Curila K,Prochazkova R,Jurak P,Jastrzebski M,Halamek J,Moskal P,Stros P,Vesela J,Waldauf P,Viscor I,Plesinger F,Sussenbek O,Herman D,Osmancik P,Smisek R,Leinveber P,Czarnecka D,Widimsky Pdoi
10.1016/j.hrthm.2019.11.016subject
Has Abstractpub_date
2020-04-01 00:00:00pages
607-614issue
4eissn
1547-5271issn
1556-3871pii
S1547-5271(19)31028-8journal_volume
17pub_type
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