Address for correspondence:
Karol Curila, MD, PhD., MSc
Cardiocenter, Third Faculty of Medicine, Charles University, Srobarova 50, 100 34 Prague, Czech Republic, Phone: + 420 267 162 621
Email: karol.curila@fnkv.cz, ORCID identifier: 0000-0003-3523-6358
Disclosures: participating research institutions filed European patent application EP 19212534.2: “Method of electrocardiographic signal processing and apparatus for performing the method.”
Funding sources: This paper was supported by the Charles University Research Program Q38, Research Centre program No. UNCE/MED/002, 260530/SVV/2020 and by the CAS project RVO:68081731, and by Ministry of Education, Youth, and Sports of the Czech Republic, project LQ1605
Abstract
Background : Right ventricular (RV) pacing causes delayed activation of remote ventricular segments. We used the UHF-ECG to describe ventricular depolarization when pacing different RV locations.
Methods : In 51 consecutive patients, temporary pacing was performed at the RV apex, anterior and lateral wall, and at the RV septum with (cSp) and without direct conductive tissue engagement (mSp) (further subclassified as RVIT and RVOT for septal inflow and outflow positions). The timing of UHF-ECG electrical activations were quantified as: left ventricular lateral wall delay (LVLWd; V8 activation delay), RV lateral wall delay (RVLWd; V1 activation delay), and LV lateral wall depolarization duration (V5-8d).
Results: The LVLWd was shortest for cSp (11 ms (95% CI; 5;17), followed by the RVIT (19 ms (11;26) and the RVOT (33 ms (27;40), (p<0.01 between all of them), although the QRSd for the latter two were the same (153 ms (148;158) vs. 153 ms (148; 158); p=0.99). The RVOT caused longer V5-8d (9 ms (3;14) compared to the RVIT (1 ms (−5;8), p<0.05. RV apical capture not only had a worse LVLWd (34 ms (26;43) compared to mSp (27 ms (20;34), p<0.05), but its RVLWd (17 ms (9;25) was also the longest compared to other RV pacing sites (mean values for cSp, mSp, anterior and lateral wall captures being below 6 ms), p<0.001 compared to each of them.