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The V6-V1 interpeak interval : a novel criterion for the diagnosis of left bundle branch capture
- Source :
- Europace
- Publication Year :
- 2022
-
Abstract
- Aims We hypothesized that during left bundle branch (LBB) area pacing, the various possible combinations of direct capture/non-capture of the septal myocardium and the LBB result in distinct patterns of right and left ventricular activation. This could translate into different combinations of R-wave peak time (RWPT) in V1 and V6. Consequently, the V6-V1 interpeak interval could differentiate the three types of LBB area capture: non-selective (ns-)LBB, selective (s-)LBB, and left ventricular septal (LVS). Methods and results Patients with unquestionable evidence of LBB capture were included. The V6-V1 interpeak interval, V6RWPT, and V1RWPT were compared between different types of LBB area capture. A total of 468 patients from two centres were screened, with 124 patients (239 electrocardiograms) included in the analysis. Loss of LVS capture resulted in an increase in V1RWPT by ≥15 ms but did not impact V6RWPT. Loss of LBB capture resulted in an increase in V6RWPT by ≥15 ms but only minimally influenced V1RWPT. Consequently, the V6-V1 interval was longest during s-LBB capture (62.3 ± 21.4 ms), intermediate during ns-LBB capture (41.3 ± 14.0 ms), and shortest during LVS capture (26.5 ± 8.6 ms). The optimal value of the V6-V1 interval value for the differentiation between ns-LBB and LVS capture was 33 ms (area under the receiver operating characteristic curve of 84.7%). A specificity of 100% for the diagnosis of LBB capture was obtained with a cut-off value of >44 ms. Conclusion The V6-V1 interpeak interval is a promising novel criterion for the diagnosis of LBB area capture.
- Subjects :
- Bundle of His
medicine.medical_specialty
Conduction system pacing
Ventricular Septum
Electrocardiography
Clinical Research
Pacing and Cardiac Resynchronization Therapy
Heart Conduction System
Physiology (medical)
Internal medicine
Left bundle branch
Left bundle branch pacing
Humans
Medicine
AcademicSubjects/MED00200
Left ventricular septal capture
Receiver operating characteristic
business.industry
Cardiac Pacing, Artificial
Left bundle branch capture
Electrocardiogram
Ventricular activation
Cardiology
Interval (graph theory)
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Europace
- Accession number :
- edsair.doi.dedup.....388b06994f88f5b4be0b88d3404862f8