RESUMEN
BACKGROUND: The presence of left bundle branch block (LBBB) represents a particular challenge in properly measuring the QT interval. Here we demonstrate the applicability of the "Bogossian formula" in pacemaker patients with LBBB due to apical or nonapical right ventricular (RV) pacing and preserved left ventricular function. METHODS: A total of 163 patients with a cardiac one- or two-chamber pacemaker were included in this prospective, multicentre observational study. Twelve-lead ECG recordings were obtained during both intrinsic rhythm and RV pacing with induced LBBB. The QT interval measured during LBBB was corrected using the Bogossian formula to obtain the "modified QT" (QTm). The QTmc interval was calculated with the Bazett formula, and this was compared with the QTc interval during intrinsic rhythm. RESULTS: Eighty-three patients (78 ± 9 years; male n = 83) with apical and eighty patients (71 ± 13 years; male n = 80) with non-apical RV pacing were included in this study. In the apical group the QTmc was determined to be 444 ± 39 ms in paced rhythm and the QTc interval 413 ± 36 ms in intrinsic rhythm. In the non-apical group these values were 430 ± 34 ms in paced and 416 ± 32 ms in intrinsic rhythm. CONCLUSION: The Bogossian formula is a reliable tool for QTc interval evaluation in pacemaker patients with LBBB due to apical or non-apical RV pacing. However, an overestimation of 30 ms should be included in the calculation.
Asunto(s)
Bloqueo de Rama/diagnóstico , Estimulación Cardíaca Artificial/métodos , Diagnóstico por Computador/métodos , Electrocardiografía , Ventrículos Cardíacos/fisiopatología , Función Ventricular Izquierda/fisiología , Anciano , Bloqueo de Rama/fisiopatología , Bloqueo de Rama/terapia , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudios Prospectivos , Reproducibilidad de los ResultadosRESUMEN
Atrial fibrillation is the most common form of cardiac arrhythmia, occurring in 1-2 % of the population and due to an increased life expectancy the prevalence will increase further. Pharmacological treatment of atrial fibrillation is an important component of basic initial therapeutic options for patients with atrial fibrillation. Independent of an individually adjusted prevention of thromboembolism, rate and rhythm management can also be carried out. While rate control mainly applies to all patients, rhythm control is only indicated in patients who remain clinically symptomatic despite sufficient rate control. Profound knowledge about antiarrhythmic drugs including specific interactions is necessary due to the variable individual effects and sometimes severe side effects.