QRS dispersion to determine electromechanical synchrony in patients undergoing permanent cardiac stimulation

Authors

Keywords:

cardiac pacing, echocardiography, left ventricular function, ventricular dyssynchrony

Abstract

Introduction: Studies to determine usefulness of QRS duration and its dispersion in patients undergoing permanent cardiac pacing from different sites are scarce. A objective was to demonstrate the relationship between mechanical synchrony of the heart evaluated by echocardiography with QRS dispersion in patients with cardiac pacing stimulated from different cardiac sites.

Methods: Three groups were studied. First group: 82 patients submitted to right ventricular apical pacing; second group, 27 patients with systolic dysfunction secondary to right ventricular apical pacing taken to high septal pacing. Third group: 19 patients undergoing cardiac resynchronization therapy. Electrocardiographic and echocardiographic variables were studied to determine if there is electromechanical synchrony relationship.

Results: First group: QRS duration and its dispersion showed significant increases correlation when decreases left ventricular ejection fraction at follow-up. Second group: Ejection fraction increased from 31% ± 3,1% to 45% ± 12% (p = 0,0041) with septal pacing; this showed a better degree of mechanical synchrony when it was evaluated by echocardiography, with significant and inverse correlation between QRS dispersion and ejection fraction. Third group: Linear correlation between ejection fraction and QRS dispersion at six months of follow-up was significant (r = 0,34 and p = 0,02); women showed greater QRS dispersion (48,0 ± 24,0 vs. 37,14 ± 13,8) ms; p = 0,04 and better response to resynchronization.

Conclusions: Right ventricular apical pacing is related to cardiac contractile deterioration; increased QRS dispersion could be an electrocardiographic variable to predict a decreased left ventricular ejection fraction. Patients underwent septal stimulation improved electromechanical synchrony; decreased QRS dispersion could predict this improvement. Finally, decreased QRS dispersion may predict a good response to resynchronization therapy.

Downloads

Download data is not yet available.

Downloads

Published

2023-05-08

How to Cite

Chávez-Gonzalez, E., Carmona Puerta, R., Rodríguez González, F., & Nodarse Concepción, A. (2023). QRS dispersion to determine electromechanical synchrony in patients undergoing permanent cardiac stimulation. Anales De La Academia De Ciencias De Cuba, 13(2), e1309. Retrieved from https://revistaccuba.sld.cu/index.php/revacc/article/view/1309

Issue

Vol. 13 No. 2: April-June 2023 (Issue in Progress)

Section

Biomedical sciences

License

The journal Anales de la Academia de Ciencias de Cuba protects copyright, and operates with a Creative Commons License 4.0 (Creative Commons Attribution-NonCommercial License 4.0). By publishing in it, authors allow themselves to copy, reproduce, distribute, publicly communicate their work and generate derivative works, as long as the original author is cited and acknowledged. They do not allow, however, the use of the original work for commercial or lucrative purposes.

The authors authorize the publication of their writings, retaining the authorship rights, and assigning and transferring to the magazine all the rights protected by the intellectual property laws that govern in Cuba, which imply editing to disseminate the work.

Authors may establish additional agreements for the non-exclusive distribution of the version of the work published in the journal (for example, placing it in an institutional repository or publishing it in a book), with recognition of having been first published in this journal.

To learn more, see https://creativecommons.org