Characterization of interventricular desynchronization in heart failure patients

  • Currently, QRS width and bundle branch block morphology are used as electrocardiographic guideline criterias to selectheart failure (HF) patients with interventricular desynchronization in sinus rhythm (SR) for cardiac resynchronisationtherapy (CRT). Nevertheless, up to 30% of these patients do not benefit from implantation of CRT systems. Esophagealleft ventricular electrogram (LVE) enablesCurrently, QRS width and bundle branch block morphology are used as electrocardiographic guideline criterias to selectheart failure (HF) patients with interventricular desynchronization in sinus rhythm (SR) for cardiac resynchronisationtherapy (CRT). Nevertheless, up to 30% of these patients do not benefit from implantation of CRT systems. Esophagealleft ventricular electrogram (LVE) enables semi-invasive measurement of interventricular conduction delays (IVCD)even in patients with atrial fibrillation (AF). To routinely apply this method, a programmer based semi-invasiveautomatic quantification of IVCD should to be developed. Our aims were todefine interventricular conduction delaysby analyzing fractionated left ventricular (LV) deflections in the esophageal left ventricular electrogram of HF patientsin SR or AF. In 66 HF patients (49 male,17 female, age 65 ± 10 years) a 5F TOslim electrode (Osypka AG, Germany) was perorallyapplied. Using BARD EP Lab, cardiac desynchronization was quantified as interval IVCD between onset of QRS insurface ECG and the investigator-determined onset of the left ventricular deflection in LVE. IVCD was compared withthe intervals between QRS onset and the first maximum (IVCDm1) and between QRS onset and the second maximum(IVCDm2) of the LV complex. QRS of 173 ± 26 ms was linked with empirical IVCD of 75 ± 25 ms, at mean. First and second LV maximum could beascertained beyond doubt in all patients. Significant correlations of the p<0,01 level were found between IVCD and theIVCDm1 of 96 ± 28 ms as well as between IVCD and the IVCDm2 of 147 ± 31 ms, at mean. To standardize automatic measurement of interventricular conduction delays with respect to patients with fractionatedLV complexes, the first maximum of the LV deflection should be utilized to qualify the IVCD of HF patients with sinusrhythm and atrial fibrillation.show moreshow less

Export metadata

Additional Services

Share in Twitter Search Google Scholar
Metadaten
Author:Kirsten-Maria Rotter, Katharina Kroll, Christoph A. Nienaber, Bruno IsmerGND
Editor:Olaf Dössel
Publisher:Walter de Gruyter
Place of publication:Berlin, Boston
Date of Publication (online):2012/09/06
Language:English
Parent Title (Multiple languages):Biomedical Engineering / Biomedizinische Technik
Volume:57
Issue:SI-1 Track-Q
ISSN:0013-5585 (Print)
ISSN:1862-278X (Online)
First Page:837
Last Page:840
Document Type:Conference Proceeding
Institutes:Hochschule Offenburg / Bibliografie
Release Date:2015/06/13
Licence (German):License LogoEs gilt das UrhG
Note:
Proceedings BMT 2012, 46. DGBMT Jahrestagung, Jena - Track Q. Personalized Medical Technology, 16.-19.09.2012
DOI:https://doi.org/10.1515/bmt-2012-4091