TY  - CHAP
U1  - Konferenzveröffentlichung
A1  - Heinke, Matthias
A1  - Dannberg, Gudrun
A1  - Heinke, Tobias
A1  - Ismer, Bruno
A1  - Haber, Tobias
A1  - Tumampos, Jonas
A1  - Kühnert, Helmut
ED  - Jaffray, David A.
T1  - Electrical Interatrial to Interventricular Conduction Delay Ratio with Focused Transesophageal Electrocardiography in Cardiac Resynchronization Therapy
T2  - World Congress on Medical Physics and Biomedical Engineering 2015 Toronto : IFMBE Proceedings
N2  - Cardiac resynchronization therapy (CRT) is an established class I level A biventricular pacing therapy in chronic heart failure patients with left bundle branch block and reduced left ventricular ejection fraction, but not all patients improved clinically. Purpose of the study was to evaluate electrical interatrial conduction delay (IACD) to interventricular conduction delay (IVCD) ratio with focused transesophageal left atrial and left ventricular electrocardiography.

Methods: Thirty eight chronic heart failure patients (age 63.4±10.2 years; 3 females, 35 males) with New York Heart Association (NYHA) functional class 3.0±0.2 and 171.71±36.17ms QRS duration were analysed using posterior left atrial and left ventricular transesophageal electrocardiography with hemispherical electrodes before CRT. Electrical IACD was measured between onset of P-wave in the surface ECG and onset of left atrial signal. Electrical IVCD was measured between onset of QRS complex in the surface ECG and onset of left ventricular signal.

Results: Electrical IACD and IVCD could be evaluated by transesophageal left atrial and left ventricular electrocardiography in all heart failure patients with correlation to 1.18±0.92 IACD-IVCD-ratio (r=-0.57, P<0.001; r=0.66, P<0.001). There were 32 CRT responder with reduction of NYHA class from 3.0±0.22 to 1.97±0.31 (P<0.001) during 16.5±18.9 month CRT with 75.19±33.49ms IACD, 78.91±24.73ms IVCD, 1.04±0.66 IACD-IVCD-ratio and correlation between IACD and IACDIVCD- ratio (r=0.84, P<0.001). There were 6 CRT nonresponder with no reduction of NYHA class from 3.0±0.3 to 2.9±0.5 during 14.3±13.7 month biventricular pacing, 50.0±28.26ms IVCD (P=0.014), 1.92±1.65 IACD-IVCD-ratio (P=0,029) and correlation between 67.0±24.9ms IACD and IACD-IVCD-ratio (r=0.85, P=0.031).

Conclusions: Focused transesophageal left atrial and left ventricular electrocardiography can be utilized to analyse electrical IACD and IVCD in heart failure patients. IACDIVDC- ratio may be a useful parameter to evaluate electrical left cardiac desynchronization in heart failure patients.
KW  - Elektrokardiogramm
Y1  - 2015
SN  - 978-3-319-19387-8 (eBook)
SB  - 978-3-319-19387-8 (eBook)
SN  - 978-3-319-19386-1 (Softcover)
SB  - 978-3-319-19386-1 (Softcover)
U6  - https://doi.org/10.1007/978-3-319-19387-8_256
DO  - https://doi.org/10.1007/978-3-319-19387-8_256
VL  - 51
SP  - 1052
EP  - 1055
PB  - Springer
CY  - Cham
ER  -