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Improvement in electrocardiographic parameters of repolarization related to sudden death in patients with ventricular dysfunction and left bundle branch block after cardiac resynchronization through His bundle pacing.
Moriña-Vázquez, Pablo; Moraleda-Salas, María Teresa; López-Masjuan-Ríos, Álvaro; Esteve-Ruiz, Irene; Arce-León, Álvaro; Lluch-Requerey, Carmen; Rodríguez-Albarrán, Adrián; Venegas-Gamero, José; Gómez-Menchero, Antonio Enrique.
Afiliación
  • Moriña-Vázquez P; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramón Jiménez (HJRJ), Ronda Norte S/N, Huelva, Spain.
  • Moraleda-Salas MT; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramón Jiménez (HJRJ), Ronda Norte S/N, Huelva, Spain. teresamoraleda@hotmail.com.
  • López-Masjuan-Ríos Á; Department of Cardiology, HJRJ, Ronda Norte S/N., Huelva, Spain.
  • Esteve-Ruiz I; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramón Jiménez (HJRJ), Ronda Norte S/N, Huelva, Spain.
  • Arce-León Á; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramón Jiménez (HJRJ), Ronda Norte S/N, Huelva, Spain.
  • Lluch-Requerey C; Department of Cardiology, HJRJ, Ronda Norte S/N., Huelva, Spain.
  • Rodríguez-Albarrán A; Department of Cardiology, HJRJ, Ronda Norte S/N., Huelva, Spain.
  • Venegas-Gamero J; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramón Jiménez (HJRJ), Ronda Norte S/N, Huelva, Spain.
  • Gómez-Menchero AE; Department of Cardiology, HJRJ, Ronda Norte S/N., Huelva, Spain.
J Interv Card Electrophysiol ; 66(9): 2003-2010, 2023 Dec.
Article en En | MEDLINE | ID: mdl-36930350
BACKGROUND: Cardiac resynchronization therapy (CRT) through permanent His bundle pacing (p-HBP) normalizes interventricular conduction disorders and QRS. Similarly, there are immediate and long-term changes in repolarization, which could be prognostic of a lower risk of sudden death (SD) at follow-up. We aimed to compare the changes in different electrocardiographic (ECG) repolarization parameters related to the risk of SD before and after CRT through p-HBP. METHODS: In this prospective, descriptive single-center study (May 2019 to December 2021), we compared the ECG parameters of repolarization related to SD in patients with non-ischemic dilated cardiomyopathy, left bundle branch block (LBBB), and CRT indications, at baseline and after CRT through p-HBP. RESULTS: Forty-three patients were included. Compared to baseline, after CRT through p-HBP, there were immediate significant changes in the QT interval (ms): 445 [407.5-480] vs 410 [385-440] (p = 0.006), QT dispersion (ms): 80 [60-100] vs 40 [40-65] (p < 0.001), Tp-Te (ms): 90 [80-110] vs 80 [60-95] (p < 0.001), Tp-Te/QT ratio: 0.22 [0.19-0.23] vs 0.19 [0.16-0.21] (p < 0.001), T wave amplitude (mm): 6.25 [4.88-10] vs - 2.5 [- 7-2.25] (p < 0.001), and T wave duration (ms): 190 [157.5-200] vs 140 [120-160] (p = 0.001). In the cases of the corrected QT (Bazzett and Friederichia) and the Tp-Te dispersion, changes only became significant at 1 month post-implant (468.5 [428.8-501.5] vs 440 [410-475.25] (p = 0.015); 462.5 [420.8-488.8] vs 440 [400-452.5] (p = 0.004), and 40 [30-52.5] vs 30 [20-40] (p < 0.001), respectively) (Table 1). Finally, two parameters did not improve until 6 months post-implant: the rdT/JT index, 0.25 [0.21-0.28] baseline vs 0.20 [0.19-0.23] 6 months post-implant (p = 0.011), and the JT interval, 300 [240-340] baseline vs 280 [257-302] 6 months post-implant (p = 0.027). Additionally, most of the parameters continued improving as compared with immediate post-implantation. CONCLUSIONS: After CRT through His bundle pacing and LBBB correction, there was an improvement in all parameters of repolarization related to increased SD reported in the literature.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular / Terapia de Resincronización Cardíaca / Insuficiencia Cardíaca Límite: Humans Idioma: En Revista: J Interv Card Electrophysiol Asunto de la revista: CARDIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular / Terapia de Resincronización Cardíaca / Insuficiencia Cardíaca Límite: Humans Idioma: En Revista: J Interv Card Electrophysiol Asunto de la revista: CARDIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Países Bajos