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Electrical Left Atrial Conduction Delay with Focused Transesophageal Electrocardiography in Cardiac Resynchronization Therapy

  • 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 responderCardiac 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.show moreshow less

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Metadaten
Document Type:Conference Proceeding
Conference Type:Konferenzartikel
Zitierlink: https://opus.hs-offenburg.de/1525
Bibliografische Angaben
Title (English):Electrical Left Atrial Conduction Delay with Focused Transesophageal Electrocardiography in Cardiac Resynchronization Therapy
Conference:World Congress on Medical Physics and Biomedical Engineering, June 7-12, 2015, Toronto, Canada
Author:Matthias HeinkeStaff MemberORCiDGND, Helmut Kühnert, Tobias Heinke, Jonas TumamposStaff MemberGND, Gudrun Dannberg
Year of Publication:2015
Place of publication:Cham
Publisher:Springer
First Page:1048
Last Page:1051
Parent Title (English):World Congress on Medical Physics and Biomedical Engineering 2015 Toronto : IFMBE Proceedings
Volume:51
ISBN:978-3-319-19387-8 (eBook)
ISBN:978-3-319-19386-1 (Softcover)
DOI:https://doi.org/10.1007/978-3-319-19387-8_255
Language:English
Inhaltliche Informationen
Institutes:Fakultät Elektrotechnik und Informationstechnik (E+I) (bis 03/2019)
Institutes:Bibliografie
GND Keyword:Eöelktrokardiogramm
Formale Angaben
Open Access: Closed Access 
Licence (German):License LogoUrheberrechtlich geschützt