Novel ultra‐high‐frequency electrocardiogram tool for the description of the ventricular depolarization pattern before and during cardiac resynchronization

Pavel JURÁK; Karol Curila; Pavel Leinveber; Frits W. Prinzen; Ivo Viscor; Filip Plesinger; Radovan Smisek; Radka Prochazkova; Pavel Osmancik; Josef Halamek; Magdalena Matejkova; Jolana Lipoldova; Miroslav Novak; Roman Panovsky; Petr Andrla; Vlastimil Vondra; Petr Stros; Jana Vesela; Dalibor Herman

doi:10.1111/jce.14299

journal article Dec 05, 2019

Novel ultra‐high‐frequency electrocardiogram tool for the description of the ventricular depolarization pattern before and during cardiac resynchronization

Pavel JURÁK

Karol Curila

Pavel Leinveber Frits W. Prinzen Ivo Viscor Filip Plesinger Radovan Smisek Radka Prochazkova Pavel Osmancik Josef Halamek

Magdalena Matejkova Jolana Lipoldova Miroslav Novak Roman Panovsky Petr Andrla Vlastimil Vondra Petr Stros Jana Vesela Dalibor Herman

Journal of Cardiovascular Electrophysiology Vol. 31 No. 1 pp. 300-307 · Wiley

View at Publisher Save 10.1111/jce.14299

Abstract

AbstractIntroductionThe present study introduces a new ultra‐high‐frequency 14‐lead electrocardiogram technique (UHF‐ECG) for mapping ventricular depolarization patterns and calculation of novel dyssynchrony parameters that may improve the selection of patients and application of cardiac resynchronization therapy (CRT).MethodsComponents of the ECG in sixteen frequency bands within the 150 to 1000 Hz range were used to create ventricular depolarization maps. The maximum time difference between the UHF QRS complex centers of mass of leads V1 to V8 was defined as ventricular electrical dyssynchrony (e‐DYS), and the duration at 50% of peak voltage amplitude in each lead was defined as the duration of local depolarization (Vd). Proof of principle measurements was performed in seven patients with left (left bundle branch block) and four patients with right bundle branch block (right bundle branch block) before and during CRT using biventricular and His‐bundle pacing.ResultsThe acquired activation maps reflect the activation sequence under the tested conditions. e‐DYS decreased considerably more than QRS duration, during both biventricular pacing (−50% vs −8%) and His‐bundle pacing (−77% vs −13%). While biventricular pacing slightly increased Vd, His‐bundle pacing reduced Vd significantly (+11% vs −36%), indicating the contribution of the fast conduction system. Optimization of biventricular pacing by adjusting VV‐interval showed a decrease of e‐DYS from 102 to 36 ms with only a small Vd increase and QRS duration decrease.ConclusionsThe UHF‐ECG technique provides novel information about electrical activation of the ventricles from a standard ECG electrode setup, potentially improving the selection of patients for CRT and application of CRT.

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Details

Published: Dec 05, 2019
Vol/Issue: 31(1)
Pages: 300-307
License: View

Authors

P

Pavel JURÁK

Institute of Scientific Instruments The Czech Academy of Sciences Brno Czech Republic

K

Karol Curila

Department of Cardiology, Cardiocenter, Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady Prague Czech Republic

P

Pavel Leinveber

International Clinical Research Center St Anneʼs University Hospital Brno Czech Republic; First Department of Internal Medicine‐Cardioangiology Faculty of Medicine of Masaryk University, St Anneʼs University Hospital Brno Czech Republic

F

Frits W. Prinzen

Department of Physiology, Cardiovascular Research Institute Maastricht Maastricht University Maastricht The Netherlands

I

Ivo Viscor

Institute of Scientific Instruments The Czech Academy of Sciences Brno Czech Republic

F

Filip Plesinger

Institute of Scientific Instruments The Czech Academy of Sciences Brno Czech Republic

R

Radovan Smisek

Institute of Scientific Instruments The Czech Academy of Sciences Brno Czech Republic; Department of Biomedical Engineering, The Faculty of Electrical Engineering and Communication Brno University of Technology Brno Czech Republic

R

Radka Prochazkova

Department of Cardiology, Cardiocenter, Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady Prague Czech Republic

P

Pavel Osmancik

Department of Cardiology, Cardiocenter, Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady Prague Czech Republic

J

Josef Halamek

Institute of Scientific Instruments The Czech Academy of Sciences Brno Czech Republic

M

Magdalena Matejkova

International Clinical Research Center St Anneʼs University Hospital Brno Czech Republic

J

Jolana Lipoldova

International Clinical Research Center St Anneʼs University Hospital Brno Czech Republic; First Department of Internal Medicine‐Cardioangiology Faculty of Medicine of Masaryk University, St Anneʼs University Hospital Brno Czech Republic

M

Miroslav Novak

International Clinical Research Center St Anneʼs University Hospital Brno Czech Republic; First Department of Internal Medicine‐Cardioangiology Faculty of Medicine of Masaryk University, St Anneʼs University Hospital Brno Czech Republic

R

Roman Panovsky

International Clinical Research Center St Anneʼs University Hospital Brno Czech Republic; First Department of Internal Medicine‐Cardioangiology Faculty of Medicine of Masaryk University, St Anneʼs University Hospital Brno Czech Republic

P

Petr Andrla

Institute of Scientific Instruments The Czech Academy of Sciences Brno Czech Republic

V

Vlastimil Vondra

Institute of Scientific Instruments The Czech Academy of Sciences Brno Czech Republic

P

Petr Stros

Department of Cardiology, Cardiocenter, Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady Prague Czech Republic

J

Jana Vesela

Department of Cardiology, Cardiocenter, Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady Prague Czech Republic

D

Dalibor Herman

Department of Cardiology, Cardiocenter, Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady Prague Czech Republic

Cite This Article

Pavel JURÁK, Karol Curila, Pavel Leinveber, et al. (2019). Novel ultra‐high‐frequency electrocardiogram tool for the description of the ventricular depolarization pattern before and during cardiac resynchronization. Journal of Cardiovascular Electrophysiology, 31(1), 300-307. https://doi.org/10.1111/jce.14299

Novel ultra‐high‐frequency electrocardiogram tool for the description of the ventricular depolarization pattern before and during cardiac resynchronization

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