TY  - CHAP
U1  - Konferenzveröffentlichung
A1  - Heinke, Matthias
A1  - Kühnert, Helmut
A1  - Heinke, Tobias
A1  - Tumampos, Jonas
A1  - Dannberg, Gudrun
T1  - Electrical Left Atrial Conduction Delay 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 biventricular pacing therapy in heart failure patients with left bundle branch block and reduced left ventricular ejection fraction, but not all patients improved clinically as CRT responder. Purpose of the study was to evaluate electrical left atrial conduction delay (LACD) with focused transesophageal electrocardiography in CRT responder and CRT non-responder.

Methods: Twenty heart failure patients (age 66.6±8.2 years; 2 females, 18 males) with New York Heart Association functional class 3.0±0.3 and 174.2±40.2ms QRS duration were analysed using posterior left atrial transesophageal electrocardiography with hemispherical electrodes. Electrical LACD was measured between onset and offset of transesophageal left atrial signal before implantation of CRT devices.

Results: Electrical LACD could be evaluated by bipolar transesophageal left atrial electrocardiography using TO Osypka electrode in all heart failure patients with negative correlation between 54.7±18.1ms LACD and 24.9±6.4% left ventricular ejection fraction (r=-0.65, P=0.002). There were 16 CRT responders with reduction of New York Heart Association functional class from 3.0±0.29 to 2.1±0.2 (r=0.522, P=0.038) during 9.41±10.96 month biventricular pacing and negative correlation between 49.6±14.2ms LACD and 26.0±6.2% left ventricular ejection fraction (r=-0.533, P=0.034). There were 4 CRT non-responders with no reduction of New York Heart Association functional class from 3.0±0.4 to 2.8±0.5 (r=0.816, P=0.184) during with 13.88±16.39 month biventricular pacing and no correlation between 75.25±19.17ms LACD and 20.75±6.4% left ventricular ejection fraction (r=-0.831, P=0.169).

Conclusions: Focused transesophageal left atrial electrocardiography can be utilized to analyse electrical LACD in heart failure patients. LACD correlated negative with left ventricular ejection fraction in CRT responders. LACD may be a useful parameter to evaluate electrical left atrial desynchronization in heart failure patients.
KW  - Eöelktrokardiogramm
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_255
DO  - https://doi.org/10.1007/978-3-319-19387-8_255
VL  - 51
SP  - 1048
EP  - 1051
PB  - Springer
CY  - Cham
ER  -