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Revista Costarricense de Cardiología
versión impresa ISSN 1409-4142
Resumen
VILLARROEL-ABREGO, Hugo y 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.
Palabras clave : Pacemakers; dyssynchrony; electrocardiography.