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首页> 外文期刊>Journal of cardiovascular electrophysiology >The relationship of bipolar left ventricular pacing stimulus intensity to cardiac depolarization and repolarization in humans with cardiac resynchronization devices.
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The relationship of bipolar left ventricular pacing stimulus intensity to cardiac depolarization and repolarization in humans with cardiac resynchronization devices.

机译：具有心脏再同步装置的人的双极左心室起搏刺激强度与心脏去极化和复极化的关系。

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BACKGROUND: Myocardial depolarization can be altered by varying pacing stimulus output. This may have implications on response rates for cardiac resynchronization therapy (CRT). The purpose of our study was to determine the relationship of left ventricular (LV) pacing stimulus intensity to measures of depolarization and repolarization in humans with CRT devices. METHODS: In 37 patients with a CRT device and bipolar LV leads, bipolar LV-only pacing from maximum output to threshold was performed. The presence of changes in depolarization was defined by predetermined changes in ECG morphology that accompanied a change in bipolar stimulus amplitude. ECG parameters and the EGMs were analyzed at various LV pacing stimulus intensities. RESULTS: Changes in ECG morphology were apparent in 70% of patients. These occurred at a mean LV stimulus amplitude of greater than 2.7 +/- 0.8 V at 1 ms. Of the patients with changes in surface ECG, the transventricular conduction time decreased from 155 +/- 41 ms at low output to 141 +/- 39 ms at high output (P < 0.01). Despite a significant reduction in QRS duration with high output, mean QTc and JTc interval increased with increasing LV stimulus strength (539 +/- 45 vs 559 +/- 46 ms (P < 0.01) and 353 +/- 31 ms vs 377 +/- 32 (P < 0.01)). CONCLUSION: Increased LV stimulus intensity, independent of RV anodal capture, is associated with faster transventricular conduction time, changes in myocardial depolarization, and longer QT intervals. These findings have important implications on the relationship of programmed LV pacing output to pacing-induced proarrhythmia and clinical CRT response rates.
机译：背景：心肌去极化可以通过改变起搏刺激输出来改变。这可能会影响心脏再同步治疗（CRT）的反应率。我们研究的目的是确定使用CRT装置的人中左心室（LV）起搏刺激强度与去极化和复极化措施之间的关系。方法：在37例具有CRT设备和双极LV导线的患者中，从最大输出到阈值进行了仅双极LV的起搏。去极化变化的存在是通过预定的ECG形态变化来定义的，该变化伴随着双极刺激幅度的变化。在各种LV起搏刺激强度下分析ECG参数和EGM。结果：70％的患者心电图形态发生明显改变。这些发生在1 ms时平均LV刺激幅度大于2.7 +/- 0.8V。在表面心电图改变的患者中，心室传导时间从低输出时的155 +/- 41 ms减少到高输出时的141 +/- 39 ms（P <0.01）。尽管高输出量QRS持续时间显着减少，但平均QTc和JTc间隔随着左室刺激强度的增加而增加（539 +/- 45 vs 559 +/- 46 ms（P <0.01）和353 +/- 31 ms vs 377 + /-32（P <0.01））。结论：增加的左室刺激强度与右心室阳极捕获无关，这与心室传导时间加快，心肌去极化改变和更长的QT间隔有关。这些发现对程序性LV起搏输出与起搏诱发的心律失常和临床CRT反应率之间的关系具有重要意义。

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