160 research outputs found
Marcapasso na Doença do Nó Sinusal - Necessidade de um Estudo Prospectivo Randomizado Comparando a Estimulaçao Bicameral com a Atrial
Marcapasso na Doença do Nó Sinusal - Necessidade de um Estudo Prospectivo Randomizado Comparando a Estimulaçao Bicameral com a Atrial
Incidence of device-related infection in 97750 patients:clinical data from the complete Danish device-cohort (1982-2018)
Sex differences in the course of implantable cardioverter defibrillator concerns (Results from the Danish national DEFIB-WOMEN study)
Patients with an implantable cardioverter defibrillator at risk of poorer psychological health during 24 months of follow-up (results from the Danish national DEFIB-WOMEN study)
New onset anxiety and depression in patients with an implantable cardioverter defibrillator during 24 months of follow-up (data from the national DEFIB-WOMEN study)
The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality:insight from Danish nationwide clinical registers
Non-invasive estimation of QLV from the standard 12-lead ECG in patients with left bundle branch block
Background: Cardiac resynchronization therapy (CRT) is a treatment for patients with heart failure and electrical dyssynchrony, i.e., left bundle branch block (LBBB) ECG pattern. CRT resynchronizes ventricular contraction with a right ventricle (RV) and a left ventricle (LV) pacemaker lead. Positioning the LV lead in the latest electrically activated region (measured from Q wave onset in the ECG to LV sensing by the left pacemaker electrode [QLV]) is associated with favorable outcome. However, optimal LV lead placement is limited by coronary venous anatomy and the inability to measure QLV non-invasively before implantation. We propose a novel non-invasive method for estimating QLV in sinus-rhythm from the standard 12-lead ECG. Methods: We obtained 12-lead ECG, LV electrograms and LV lead position in a standard LV 17-segment model from procedural recordings from 135 standard CRT recipients. QLV duration was measured post-operatively. Using a generic heart geometry and corresponding forward model for ECG computation, the electrical activation pattern of the heart was fitted to best match the 12-lead ECG in an iterative optimization procedure. This procedure initialized six activation sites associated with the His-Purkinje system. The initial timing of each site was based on the directions of the vectorcardiogram (VCG). Timing and position of the sites were then changed iteratively to improve the match between simulated and measured ECG. Noninvasive estimation of QLV was done by calculating the time difference between Q-onset on the computed ECG and the activation time corresponding to centroidal epicardial activation time of the segment where the LV electrode is positioned. The estimated QLV was compared to the measured QLV. Further, the distance between the actual LV position and the estimated LV position was computed from the generic ventricular model. Results: On average there was no difference between QLV measured from procedural recordings and non-invasive estimation of QLV ( [Formula: see text] ). Median distance between actual LV pacing site and the estimated pacing site was 18.6 mm (IQR 17.3 mm). Conclusion: Using the standard 12-lead ECG and a generic heart model it is possible to accurately estimate QLV. This method may potentially be used to support patient selection, optimize implant procedures, and to simulate optimal stimulation parameters prior to pacemaker implantation
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