Publication detail

Novel ultra-high-frequency electrocardiogram tool for the description of the ventricular depolarization pattern before and during cardiac resynchronization

JURÁK, P. ČURILA, K. LEINVEBER, P. PRINZEN, F. VIŠČOR, I. PLEŠINGER, F. SMÍŠEK, R. PROCHÁZKOVÁ, R. OSMANČÍK, P. HALÁMEK, J.

Original Title

Novel ultra-high-frequency electrocardiogram tool for the description of the ventricular depolarization pattern before and during cardiac resynchronization

Type

journal article in Web of Science

Language

English

Original Abstract

Introduction The present study introduces a new ultra-high-frequency 14-lead electrocardiogram technique (UHF-ECG) for mapping ventricular depolarization patterns and calculation of novel dyssynchrony parameters that may improve the selection of patients and application of cardiac resynchronization therapy (CRT). Methods Components of the ECG in sixteen frequency bands within the 150 to 1000 Hz range were used to create ventricular depolarization maps. The maximum time difference between the UHF QRS complex centers of mass of leads V1 to V8 was defined as ventricular electrical dyssynchrony (e-DYS), and the duration at 50% of peak voltage amplitude in each lead was defined as the duration of local depolarization (Vd). Proof of principle measurements was performed in seven patients with left (left bundle branch block) and four patients with right bundle branch block (right bundle branch block) before and during CRT using biventricular and His-bundle pacing. Results The acquired activation maps reflect the activation sequence under the tested conditions. e-DYS decreased considerably more than QRS duration, during both biventricular pacing (-50% vs -8%) and His-bundle pacing (-77% vs -13%). While biventricular pacing slightly increased Vd, His-bundle pacing reduced Vd significantly (+11% vs -36%), indicating the contribution of the fast conduction system. Optimization of biventricular pacing by adjusting VV-interval showed a decrease of e-DYS from 102 to 36 ms with only a small Vd increase and QRS duration decrease. Conclusions The UHF-ECG technique provides novel information about electrical activation of the ventricles from a standard ECG electrode setup, potentially improving the selection of patients for CRT and application of CRT.

Keywords

biventricular pacing; cardiac resynchronization therapy; His-bundle pacing; ultra-high-frequency ECG; ventricular electrical dyssynchrony

Authors

JURÁK, P.; ČURILA, K.; LEINVEBER, P.; PRINZEN, F.; VIŠČOR, I.; PLEŠINGER, F.; SMÍŠEK, R.; PROCHÁZKOVÁ, R.; OSMANČÍK, P.; HALÁMEK, J.

Released

31. 1. 2020

Publisher

WILEY

Location

HOBOKEN

ISBN

1540-8167

Periodical

Journal of Cardiovascular Electrophysiology

Year of study

30

Number

12

State

United States of America

Pages from

300

Pages to

307

Pages count

8

URL

https://onlinelibrary.wiley.com/doi/full/10.1111/jce.14299?af=R

BibTex

@article{BUT160572,
  author="Pavel {Jurák} and Karol {Čurila} and Pavel {Leinveber} and Frits {Prinzen} and Ivo {Viščor} and Filip {Plešinger} and Radovan {Smíšek} and Radka {Procházková} and Pavel {Osmančík} and Josef {Halámek}",
  title="Novel ultra-high-frequency electrocardiogram tool for the description of the ventricular depolarization pattern before and during cardiac resynchronization",
  journal="Journal of Cardiovascular Electrophysiology",
  year="2020",
  volume="30",
  number="12",
  pages="300--307",
  doi="10.1111/jce.14299",
  issn="1540-8167",
  url="https://onlinelibrary.wiley.com/doi/full/10.1111/jce.14299?af=R"
}