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Revista Costarricense de Cardiología
Print version ISSN 1409-4142
Abstract
VILLARROEL-ABREGO, Hugo and GARILLO, Raúl. Stimulation of the right ventricle as a cause and aggravating ventricular dyssynchrony. Rev. costarric. cardiol [online]. 2018, vol.20, n.2, pp.6-12. ISSN 1409-4142.
Stimulation of the right ventricle as a cause and aggravating ventricular yssynchrony
Introduction and objectives:
Artificial electrical activation of the heart in patients with permanent right ventricular stimulation is responsible for ventricular dyssynchrony. Synchromax® is an electrocardiogram monitor that allows an instantaneous and noninvasive verification of intraventricular synchrony, making a comparative analysis of the antipode leads DII and V6; cut values for a resulting index are available to diagnose dyssynchrony and define its severity. The present study objective is to measure with Synchromax® the dyssynchrony index generated by right ventricular stimulation in patients with implanted pacemakers, comparing with the index during native rhythm.
Methods:
Between September 2018 and January 2019, 18 patients of both genders with unicameral, bicameral, cardio-defibrillator or resynchronization pacemakers were studied. ECG were registered with Synchromax® in all patients, with native rhythm and under artificial stimulation.
Results
Thirteen out of eighteen patients deteriorated their synchrony (72.2%) due to artificial stimulation, the other five remained with unchanged dyssynchrony index. Seven out of those thirteen cases reached a severe degree of dyssynchrony (53.8%). The ANOVA test confirmed a statistically significant difference between the pre- and post-stimulation (p <0.01); it was also confirmed that the apical implant causes more dyssynchrony than the septal implant (p=0.036).
Conclusion:
Synchromax® allows detection of electrical dyssynchrony induced by right ventricular stimulation. It is suggested that the implants could be guided with this easy to use, reproducible and operator independent technology.
Keywords : Pacemakers; dyssynchrony; electrocardiography.