<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1409-4142</journal-id>
<journal-title><![CDATA[Revista Costarricense de Cardiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. costarric. cardiol]]></abbrev-journal-title>
<issn>1409-4142</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Cardiología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-41422019000200029</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Estimulación parahisiana guiada por un índice de correlación cruzada con dos derivaciones electrocardiográficas]]></article-title>
<article-title xml:lang="en"><![CDATA[Parahisian stimulation guided by a cross-correlation index with two electrocardiographic leads]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vives Rodríguez]]></surname>
<given-names><![CDATA[Enrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araya Gómez]]></surname>
<given-names><![CDATA[Vivien]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gutiérrez Sotelo]]></surname>
<given-names><![CDATA[Oswaldo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Solís Solís]]></surname>
<given-names><![CDATA[Luis Diego]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arguedas Jiménez]]></surname>
<given-names><![CDATA[Hugo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Logarzo]]></surname>
<given-names><![CDATA[Emilio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Rafael A. Calderón Guardia Servicio de Cardiología Unidad de Arritmias]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Clínica Bíblica Servicio de Cardiología ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Cardiológico Integral  ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital México Servicio de Cardiología ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital Universitario Austral Clínica San Camilo ]]></institution>
<addr-line><![CDATA[Buenos Aires ]]></addr-line>
<country>Argentina</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<volume>21</volume>
<numero>2</numero>
<fpage>29</fpage>
<lpage>34</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-41422019000200029&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-41422019000200029&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-41422019000200029&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción.  La estimulación apical del ventrículo derecho (VD) produce un patrón de activación similar al bloqueo de rama izquierda, el cual retrasa la activación de la pared lateral del ventrículo izquierdo. El &#8220;índice de disincronía&#8221; (ID) correlaciona las derivadas DII y V6 como marcadores de la despolarización septal y lateral; en el presente reporte, se utilizó el ID para el implante del electrodo ventricular en la región &#8220;parahisiana&#8221;.  Métodos. Se incluyeron 6 pacientes a quienes se realizó un implante electivo de marcapasos bicameral, bajo indicaciones convencionales. En cada paciente se registró un electrocardiograma de 12 derivaciones en reposo, bajo estimulación apical en el (VD) y bajo estimulación septal &#8220;parahisiana&#8221;; en cada uno se obtuvo el ID.  Resultados. Se analizaron 18 electrocardiogramas de 6 pacientes, edad promedio 72±16.7 años (48-91) 2 mujeres; en 4, la indicación del implante fue bloqueo atrioventricular completo y en 2, enfermedad del nodo sinusal. En todos los pacientes se observó mejoría del ID con estimulación parahisiana, con respecto al ápex del VD y en la mayoría también con respecto al ritmo de base. No se observó correlación entre la duración del complejo QRS y el ID.  Conclusión. El uso del ID utilizando las derivaciones II/V6 permite valorar la disincronía eléctrica, en forma sencilla, no invasiva y en tiempo real.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  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 &#8220;dyssynchrony index&#8221; (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 &#8220;parahisian&#8221; 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 &#8220;parahisian&#8221; 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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[marcapasos]]></kwd>
<kwd lng="es"><![CDATA[disincronía]]></kwd>
<kwd lng="es"><![CDATA[estimulación parahisiana]]></kwd>
<kwd lng="en"><![CDATA[pacemaker]]></kwd>
<kwd lng="en"><![CDATA[dyssynchrony]]></kwd>
<kwd lng="en"><![CDATA[parahsian stimulation]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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