gms | German Medical Science

33. Internationale Konferenz für Elektrokardiographie

Internationale Konferenz für Elektrokardiographie

Interventricular delay less than 20 milliseconds on body surface potential mapping identifies cardiac resynchorisation therapy responders

Meeting Abstract

  • corresponding author presenting/speaker C. A. Pastore - Heart Institute (InCor), USP Medical School, Sao Paulo, Brasilien
  • N. Samesima - Heart Institute (InCor), USP Medical School, Sao Paulo, Brasilien
  • N.M.M.O. Tobias - Heart Institute (InCor), USP Medical School, Sao Paulo, Brasilien
  • M. Martinelli Filho - Heart Institute (InCor), USP Medical School, Sao Paulo, Brasilien
  • A.A. Pedrosa - Heart Institute (InCor), USP Medical School, Sao Paulo, Brasilien
  • S.A.D. Nishioka - Heart Institute (InCor), USP Medical School, Sao Paulo, Brasilien
  • R.A. Douglas - Heart Institute (InCor), USP Medical School, Sao Paulo, Brasilien
  • J.A.F. Ramires - Heart Institute (InCor), USP Medical School, Sao Paulo, Brasilien

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice019

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/ice2006/06ice019.shtml

Veröffentlicht: 8. Februar 2007

© 2007 Pastore et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Clinical/functional parameters currently identify patients who benefit from the cardiac resynchronization therapy (CRT). Electrical and mechanical alterations in both ventricles have not been well evaluated yet.

Objective: To establish ventricular electrical activation criteria that can distinguish patients whose clinical-functional parameters improved after CRT, using a non-invasive method, the body surface potential mapping (BSPM).

Methods: Twenty-two patients with heart failure and left bundle-branch block (LBBB) undergoing CRT, mean age 64+/-10 years, left ventricle ejection fraction (LVEF) 30%+/-8%, QRS 169+/-19 ms, NYHA class III – 86%, IV – 14%, underwent 87-lead BSPM assessment (58 leads on the anterior chest and 29 on the back), before and after CRT. BSPM isochronal maps were used to analyze the ventricular activation time (VAT) in the right (RV) and left ventricles (LV) in three situations, (1) native LBBB, (2) single-site RV pacing, and (3) biventricular pacing. CRT clinical/functional improvement was measured by LVEF on echocardiography, and by NYHA functional class. VAT’s were compared using the Mann-Whitney’s non-parametric method. The groups with and without clinical/functional improvement who showed RV/LV difference of VAT less than or equal to 20ms, and >20ms were compared by the Fisher’s test. Significance level was P<0.05.

Results: Although only a trend towards a shorter VAT RV/LV difference during biventricular pacing was found among patients who improved (12.9+/-10.9ms vs 23.1+/-12.9ms, respectively; P=0.08), the majority of the patients with clinical/functional improvement had a VAT RV/LV difference shorter than or equal to 20 ms during biventricular pacing, P=0.026 (79% vs 25%, RR 2.5, CI=95% 0.09–6.58). Baseline characteristics were not significant. Conclusion: BSPM could distinguish patients who improved clinically-functionally after CRT when VAT difference between the ventricles was shorter than 20 ms.