Biventricular Paced QRS Area Predicts Acute Hemodynamic CRT Response Better Than QRS Duration or QRS Amplitudes.
Paced QRS Area Predicts CRT Response Introduction Vectorcardiographic (VCG) QRS area of left bundle branch block (LBBB) predicts acute hemodynamic response in cardiac resynchronization therapy (CRT) patients. We hypothesized that changes in QRS area occurring with biventricular pacing (BV) might pre...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 28; no. 2; pp. 192 - 201 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Feb2017
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121236295&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121236295 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Feb2017 vid: 28 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 121236295 121236295 121236295 10.1111/jce.13132 121236295 ppf: 192 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Biventricular Paced QRS Area Predicts Acute Hemodynamic CRT Response Better Than QRS Duration or QRS Amplitudes. aug: au: DE POOTER, JAN EL HADDAD, MILAD DE BUYZERE, MARC ARANDA, HERNANDEZ ALFONSO CORNELUSSEN, RICHARD STEGEMANN, BERTHOLD RINALDI, CHRISTOPHER A. STERLINSKI, MACIEJ SOKAL, ADAM FRANCIS, DARREL P. JORDAENS, LUC STROOBANDT, ROLAND X. VAN HEUVERSWYN, FREDERIC TIMMERMANS, FRANK affil: Ghent University Hospital, Heart Center, Ghent Belgium sug: subj: Hemodynamics Cardiac Resynchronization Therapy Bundle-Branch Block Heart Conduction System Human Time Factors Treatment Outcomes Vectorcardiography Heart Failure Ventricular Function, Left Mann-Whitney U Test Wilcoxon Rank Sum Test Data Analysis Software Two-Tailed Test ab: Paced QRS Area Predicts CRT Response Introduction Vectorcardiographic (VCG) QRS area of left bundle branch block (LBBB) predicts acute hemodynamic response in cardiac resynchronization therapy (CRT) patients. We hypothesized that changes in QRS area occurring with biventricular pacing (BV) might predict acute hemodynamic CRT response (AHR). Methods and Results VCGs of 624 BV paced electrocardiograms (25 LBBB patients with 35 different pacing configurations) were calculated according to Frank's orthogonal lead system. Maximum QRS vector amplitudes (XAmpl, YAmpl, ZAmpl, and 3DAmp) and QRS areas (XArea, YArea, ZArea, and 3DArea) in the orthogonal leads (X, Y, and Z) and in 3-dimensional projection were measured. Volume of the 3D vector loop and global QRS duration (QRSD) on the surface electrocardiogram were assessed. Differences (Δ) in VCG parameters between BV paced and LBBB QRS complexes were calculated. An increase of 10% in dP/dt max was considered as AHR. LBBB conduction is characterized by a large ZArea (109 μVs, interquartile range [IQR]:75;135), significantly larger than XArea (22 μVs, IQR:10;57) and YArea (44 μVs, IQR:32;62, P < 0.001). Overall, QRS duration, amplitudes, and areas decrease significantly with BV pacing (P < 0.001). Of all VCG parameters, 3DAmpl, Δ3DAmpl, ZArea, ΔZArea, Δ3DArea, and ΔQRSD differentiate AHR response from nonresponse (P < 0.05). ΔZArea predicted best positive AHR (area under the curve = 0.813) and outperformed any other VCG parameter or QRSD measurement. Conclusion Of all VCG parameters, reduction in QRS area, calculated in Frank's Z lead, predicts acute hemodynamic response best. This method might be an easy, noninvasive tool to guide CRT implantation and optimization. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|