Pavel Jurak1, Karol Curila2, Pavel Leinveber3,4, Frits W Prinzen5, Ivo Viscor1, Filip Plesinger1, Radovan Smisek1,6, Radka Prochazkova2, Pavel Osmancik2, Josef Halamek1, Magdalena Matejkova3, Jolana Lipoldova3,4, Miroslav Novak3,4, Roman Panovsky3,4, Petr Andrla1, Vlastimil Vondra1, Petr Stros2, Jana Vesela2, Dalibor Herman2. 1. Institute of Scientific Instruments, The Czech Academy of Sciences, Brno, Czech Republic. 2. Department of Cardiology, Cardiocenter, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic. 3. International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic. 4. First Department of Internal Medicine-Cardioangiology, Faculty of Medicine of Masaryk University, St Anne's University Hospital, Brno, Czech Republic. 5. Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands. 6. Department of Biomedical Engineering, The Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic.
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.
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.
Authors: Pavel Jurak; Laura R Bear; Uyên Châu Nguyên; Ivo Viscor; Petr Andrla; Filip Plesinger; Josef Halamek; Vlastimil Vondra; Emma Abell; Matthijs J M Cluitmans; Rémi Dubois; Karol Curila; Pavel Leinveber; Frits W Prinzen Journal: Sci Rep Date: 2021-06-01 Impact factor: 4.379
Authors: Karol Curila; Pavel Jurak; Kevin Vernooy; Marek Jastrzebski; Petr Waldauf; Frits Prinzen; Josef Halamek; Marketa Susankova; Lucie Znojilova; Radovan Smisek; Jakub Karch; Filip Plesinger; Pawel Moskal; Luuk Heckman; Jan Mizner; Ivo Viscor; Vlastimil Vondra; Pavel Leinveber; Pavel Osmancik Journal: Front Cardiovasc Med Date: 2021-12-07