Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization

Karol Curila; Pavel Jurak; Marek Jastrzebski; Frits Prinzen; Petr Waldauf; Josef Halamek; Kevin Vernooy; Radovan Smisek; Jakub Karch; Filip Plesinger; Pawel Moskal; Marketa Susankova; Lucie Znojilova; Luuk Heckman; Ivo Viscor; Vlastimil Vondra; Pavel Leinveber; Pavel Osmancik

doi:10.1016/j.hrthm.2021.04.025

Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization

Karol Curila^*, Pavel Jurak, Marek Jastrzebski, Frits Prinzen, Petr Waldauf, Josef Halamek, Kevin Vernooy, Radovan Smisek, Jakub Karch, Filip Plesinger, Pawel Moskal, Marketa Susankova, Lucie Znojilova, Luuk Heckman, Ivo Viscor, Vlastimil Vondra, Pavel Leinveber, Pavel Osmancik

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND Nonselective His-bundle pacing (nsHBp), nonselective left bundle branch pacing (nsLBBp), and left ventricular septal myocardial pacing (LVSP) are recognized as physiological pacing tech niques.

OBJECTIVE The purpose of this study was to compare differences in ventricular depolarization between these techniques using ultrahigh-frequency electrocardiography (UHF-ECG).

METHODS In patients with bradycardia, nsHBp, nsLBBp (confirmed concomitant left bundle branch [LBB] and myocardial capture), and LVSP (pacing in left ventricular [LV] septal position without proven LBB capture) were performed. Timings of ventricular activations in precordial leads were displayed using UHF-ECG, and electrical dyssynchrony (e-DYS) was calculated as the difference between the first and last activation. Duration of local depolarization (Vd) was determined as width of the UHF-QRS complex at 50% of its amplitude.

RESULTS In 68 patients, data were collected during nsLBBp (35), LVSP (96), and nsHBp (55). nsLBBp resulted in larger e-DYS than did LVSP and nsH Bp [- 24 ms (-28;-19) vs -12 ms (-16;-9) vs 10 ms (7;14), respectively; P

CONCLUSION nslbbp preserves physiological LV depolarization but increases interventricular electrical dyssynchrony. LV lateral wall depolarization during LVSP is prolonged, but interventricular synchrony is preserved.

Original language	English
Pages (from-to)	1281-1289
Number of pages	9
Journal	Heart Rhythm
Volume	18
Issue number	8
DOIs	https://doi.org/10.1016/j.hrthm.2021.04.025
Publication status	Published - Aug 2021

Keywords

Depolarization duration
Dyssynchrony
His-bundle pacing
Left bundle branch pacing
Left ventricular septal myocardial pacing
Ultra-high-frequency electrocardiography
HIS-BUNDLE

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Cite this

Curila, K., Jurak, P., Jastrzebski, M., Prinzen, F., Waldauf, P., Halamek, J., Vernooy, K., Smisek, R., Karch, J., Plesinger, F., Moskal, P., Susankova, M., Znojilova, L., Heckman, L., Viscor, I., Vondra, V., Leinveber, P., & Osmancik, P. (2021). Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization. Heart Rhythm, 18(8), 1281-1289. https://doi.org/10.1016/j.hrthm.2021.04.025

@article{c89446222e9f42e1863dc6bf0f271e85,

title = "Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization",

abstract = "BACKGROUND Nonselective His-bundle pacing (nsHBp), nonselective left bundle branch pacing (nsLBBp), and left ventricular septal myocardial pacing (LVSP) are recognized as physiological pacing tech niques.OBJECTIVE The purpose of this study was to compare differences in ventricular depolarization between these techniques using ultrahigh-frequency electrocardiography (UHF-ECG).METHODS In patients with bradycardia, nsHBp, nsLBBp (confirmed concomitant left bundle branch [LBB] and myocardial capture), and LVSP (pacing in left ventricular [LV] septal position without proven LBB capture) were performed. Timings of ventricular activations in precordial leads were displayed using UHF-ECG, and electrical dyssynchrony (e-DYS) was calculated as the difference between the first and last activation. Duration of local depolarization (Vd) was determined as width of the UHF-QRS complex at 50% of its amplitude.RESULTS In 68 patients, data were collected during nsLBBp (35), LVSP (96), and nsHBp (55). nsLBBp resulted in larger e-DYS than did LVSP and nsH Bp [- 24 ms (-28;-19) vs -12 ms (-16;-9) vs 10 ms (7;14), respectively; PCONCLUSION nslbbp preserves physiological LV depolarization but increases interventricular electrical dyssynchrony. LV lateral wall depolarization during LVSP is prolonged, but interventricular synchrony is preserved.",

keywords = "Depolarization duration, Dyssynchrony, His-bundle pacing, Left bundle branch pacing, Left ventricular septal myocardial pacing, Ultra-high-frequency electrocardiography, HIS-BUNDLE",

author = "Karol Curila and Pavel Jurak and Marek Jastrzebski and Frits Prinzen and Petr Waldauf and Josef Halamek and Kevin Vernooy and Radovan Smisek and Jakub Karch and Filip Plesinger and Pawel Moskal and Marketa Susankova and Lucie Znojilova and Luuk Heckman and Ivo Viscor and Vlastimil Vondra and Pavel Leinveber and Pavel Osmancik",

note = "Funding Information: Funding sources: This study was supported by the Charles University Research Program Q38, Research Centre Program No. UNCE/MED/002, 260530/SVV/2020; CAS Project RVO:68081731. Disclosures: Participating research institutions filed European patent application EP 19212534.2: “Method of Electrocardiographic Signal Processing and Apparatus for Performing The Method.” Publisher Copyright: {\textcopyright} 2021 Heart Rhythm Society",

year = "2021",

month = aug,

doi = "10.1016/j.hrthm.2021.04.025",

language = "English",

volume = "18",

pages = "1281--1289",

journal = "Heart Rhythm",

issn = "1547-5271",

publisher = "Elsevier Science",

number = "8",

}

Curila, K, Jurak, P, Jastrzebski, M, Prinzen, F, Waldauf, P, Halamek, J, Vernooy, K, Smisek, R, Karch, J, Plesinger, F, Moskal, P, Susankova, M, Znojilova, L, Heckman, L, Viscor, I, Vondra, V, Leinveber, P & Osmancik, P 2021, 'Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization', Heart Rhythm, vol. 18, no. 8, pp. 1281-1289. https://doi.org/10.1016/j.hrthm.2021.04.025

Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization. / Curila, Karol; Jurak, Pavel; Jastrzebski, Marek et al.
In: Heart Rhythm, Vol. 18, No. 8, 08.2021, p. 1281-1289.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization

AU - Curila, Karol

AU - Jurak, Pavel

AU - Jastrzebski, Marek

AU - Prinzen, Frits

AU - Waldauf, Petr

AU - Halamek, Josef

AU - Vernooy, Kevin

AU - Smisek, Radovan

AU - Karch, Jakub

AU - Plesinger, Filip

AU - Moskal, Pawel

AU - Susankova, Marketa

AU - Znojilova, Lucie

AU - Heckman, Luuk

AU - Viscor, Ivo

AU - Vondra, Vlastimil

AU - Leinveber, Pavel

AU - Osmancik, Pavel

N1 - Funding Information: Funding sources: This study was supported by the Charles University Research Program Q38, Research Centre Program No. UNCE/MED/002, 260530/SVV/2020; CAS Project RVO:68081731. Disclosures: Participating research institutions filed European patent application EP 19212534.2: “Method of Electrocardiographic Signal Processing and Apparatus for Performing The Method.” Publisher Copyright: © 2021 Heart Rhythm Society

PY - 2021/8

Y1 - 2021/8

N2 - BACKGROUND Nonselective His-bundle pacing (nsHBp), nonselective left bundle branch pacing (nsLBBp), and left ventricular septal myocardial pacing (LVSP) are recognized as physiological pacing tech niques.OBJECTIVE The purpose of this study was to compare differences in ventricular depolarization between these techniques using ultrahigh-frequency electrocardiography (UHF-ECG).METHODS In patients with bradycardia, nsHBp, nsLBBp (confirmed concomitant left bundle branch [LBB] and myocardial capture), and LVSP (pacing in left ventricular [LV] septal position without proven LBB capture) were performed. Timings of ventricular activations in precordial leads were displayed using UHF-ECG, and electrical dyssynchrony (e-DYS) was calculated as the difference between the first and last activation. Duration of local depolarization (Vd) was determined as width of the UHF-QRS complex at 50% of its amplitude.RESULTS In 68 patients, data were collected during nsLBBp (35), LVSP (96), and nsHBp (55). nsLBBp resulted in larger e-DYS than did LVSP and nsH Bp [- 24 ms (-28;-19) vs -12 ms (-16;-9) vs 10 ms (7;14), respectively; PCONCLUSION nslbbp preserves physiological LV depolarization but increases interventricular electrical dyssynchrony. LV lateral wall depolarization during LVSP is prolonged, but interventricular synchrony is preserved.

AB - BACKGROUND Nonselective His-bundle pacing (nsHBp), nonselective left bundle branch pacing (nsLBBp), and left ventricular septal myocardial pacing (LVSP) are recognized as physiological pacing tech niques.OBJECTIVE The purpose of this study was to compare differences in ventricular depolarization between these techniques using ultrahigh-frequency electrocardiography (UHF-ECG).METHODS In patients with bradycardia, nsHBp, nsLBBp (confirmed concomitant left bundle branch [LBB] and myocardial capture), and LVSP (pacing in left ventricular [LV] septal position without proven LBB capture) were performed. Timings of ventricular activations in precordial leads were displayed using UHF-ECG, and electrical dyssynchrony (e-DYS) was calculated as the difference between the first and last activation. Duration of local depolarization (Vd) was determined as width of the UHF-QRS complex at 50% of its amplitude.RESULTS In 68 patients, data were collected during nsLBBp (35), LVSP (96), and nsHBp (55). nsLBBp resulted in larger e-DYS than did LVSP and nsH Bp [- 24 ms (-28;-19) vs -12 ms (-16;-9) vs 10 ms (7;14), respectively; PCONCLUSION nslbbp preserves physiological LV depolarization but increases interventricular electrical dyssynchrony. LV lateral wall depolarization during LVSP is prolonged, but interventricular synchrony is preserved.

KW - Depolarization duration

KW - Dyssynchrony

KW - His-bundle pacing

KW - Left bundle branch pacing

KW - Left ventricular septal myocardial pacing

KW - Ultra-high-frequency electrocardiography

KW - HIS-BUNDLE

U2 - 10.1016/j.hrthm.2021.04.025

DO - 10.1016/j.hrthm.2021.04.025

M3 - Article

C2 - 33930549

SN - 1547-5271

VL - 18

SP - 1281

EP - 1289

JO - Heart Rhythm

JF - Heart Rhythm

IS - 8

ER -