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Author Nguyên, Uyên Châu ♦ Potse, Mark ♦ Vernooy, Kevin ♦ Mafi-Rad, Masih ♦ Heijman, Jordi ♦ Caputo, Maria Luce ♦ Conte, Giulio ♦ Regoli, François ♦ Krause, Rolf ♦ Moccetti, Tiziano ♦ Auricchio, Angelo ♦ Prinzen, Frits W. ♦ Maffessanti, Francesco
Source Hyper Articles en Ligne (HAL)
Content type Text
Publisher Oxford University Press (OUP): Policy B
File Format PDF
Language English
Subject Keyword Left bundle branch block ♦ Anisotropy ♦ Computer models ♦ Activation sequence ♦ Voltage amplitude ♦ Intra-cardiac electrogram ♦ Heart failure ♦ sdv ♦ Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract Aims The aim of this study was to investigate the influence of the activation sequence on voltage amplitudes by evaluating regional voltage differences during a left bundle branch block (LBBB) activation sequence vs. a normal synchronous activation sequence and by evaluating pacing-induced voltage differences. Twenty-one patients and three computer models without scar were studied. Regional voltage amplitudes were evaluated in nine LBBB patients who underwent endocardial electro-anatomic mapping (EAM). Pacing-induced voltage differences were evaluated in 12 patients who underwent epicardial EAM during intrinsic rhythm and right ven-tricular (RV) pacing. Three computer models customized for LBBB patients were created. Changes in voltage amplitudes after an LBBB (intrinsic), a normal synchronous, an RV pacing, and a left ventricular pacing activation sequence were assessed in the computer models. Unipolar voltage amplitudes in patients were approximately ~4.5 mV (4.4-4.7 mV, ~33%) lower in the septum when compared with other segments. A normal synchronous activation sequence in the computer models normalized voltage amplitudes in the septum. Pacing-induced differences were larger in electrograms with higher voltage amplitudes during intrinsic rhythm and furthermore larger and more variable at the epicardium [mean absolute difference: 3.6-6.2 mV, 40-53% of intrinsic value; interquartile range (IQR) differences: 53-63% of intrinsic value] compared to the endocardium (mean absolute difference: 3.3-3.8 mV, 28
ISSN 10995129
Educational Use Research
Learning Resource Type Article
Publisher Date 2018-11-01
e-ISSN 15322092
Journal EP-Europace
Volume Number 20