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Revista Costarricense de Cardiología
Print version ISSN 1409-4142
Abstract
VIVES RODRIGUEZ, Enrique et al. Parahisian stimulation guided by a cross-correlation index with two electrocardiographic leads. Rev. costarric. cardiol [online]. 2019, vol.21, n.2, pp.29-34. ISSN 1409-4142.
Introduction.
Right ventricle (RV) apical stimulation produces an activation pattern similar to the left bundle Branch block, which delays the lateral wall of the left ventricle activation. The “dyssynchrony index” (ID) correlates DII and V6 leads as surrogate markers of septal and lateral depolarization; in this report, the ID for the ventricular electrode implantin the “parahisian” region was used.
Methods.
Six patients were included who underwent an elective dual chamber pacemaker implant, under conventional indications. In each patient, a 12-lead electrocardiogram was recorded at rest, under RV apical stimulation and under “parahisian” septal stimulation; in each one, the ID was obtained.
Results.
Eighteen electrocardiograms of 6 patients were analysed, average age 72 ± 16.7 years (48-91) 2 women; in 4, the indication of the implant was complete atrioventricular block and in 2, sinus node disease. In all patients, improvement of the ID with parahisian stimulation was observed, with respect to the RV apex, and in most of them, also with respect to the base rhythm. No correlation was observed between the QRS complex duration and the ID.
Conclusión
The use of the ID using leads II/V6 allows the evaluation of electrical dyssynchrony, in a simple, non-invasive way and in real time.
Keywords : pacemaker; dyssynchrony; parahsian stimulation.