Karol Curila1, Radka Prochazkova2, Pavel Jurak3, Marek Jastrzebski4, Josef Halamek3, Pawel Moskal4, Petr Stros2, Jana Vesela2, Petr Waldauf5, Ivo Viscor3, Filip Plesinger3, Ondrej Sussenbek2, Dalibor Herman2, Pavel Osmancik2, Radovan Smisek3, Pavel Leinveber6, Danuta Czarnecka4, Petr Widimsky2. 1. Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. Electronic address: karol.curila@fnkv.cz. 2. Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. 3. Institute of Scientific Instruments, The Czech Academy of Sciences, Brno, Czech Republic. 4. First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland. 5. Department of Anesthesia and Intensive Care, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. 6. International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.
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.
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.
Authors: Ahran D Arnold; Matthew J Shun-Shin; Nadine Ali; Daniel Keene; James P Howard; Ji-Jian Chow; Norman A Qureshi; Michael Koa-Wing; Mark Tanner; David C Lefroy; Nick W F Linton; Fu Siong Ng; Phang Boon Lim; Nicholas S Peters; Prapa Kanagaratnam; Darrel P Francis; Zachary I Whinnett Journal: Heart Rhythm O2 Date: 2021-08-11
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: Ahran D Arnold; James P Howard; Aiswarya A Gopi; Cheng Pou Chan; Nadine Ali; Daniel Keene; Matthew J Shun-Shin; Yousif Ahmad; Ian J Wright; Fu Siong Ng; Nick W F Linton; Prapa Kanagaratnam; Nicholas S Peters; Daniel Rueckert; Darrel P Francis; Zachary I Whinnett Journal: Cardiovasc Digit Health J Date: 2020 Jul-Aug