Electrocardiographic markers of cardiac resynchronization therapy response: delayed time to intrinsicoid deflection onset in lateral leads
Rubén KA Tapia-Orihuela1
S Michael Gharacholou2
Samuel J Asirvatham3
Freddy Del-Carpio Munoz3
1.Department of Medicine,Universidad Nacional Mayor de San Marcos,Facultad de Medicina de San Fernando,Lima,Peru2.Department of Cardiovascular Diseases,Mayo Clinic,Jacksonville,FL,USA3.Department of Cardiovascular Diseases,Mayo Clinic,Rochester,MN,USA
摘要：Cardiac resynchronization therapy (CRT) has emerged as an important intervention for patients with heart fail-ure (HF) with reduced ejection fraction and delayed ventricular activation. In these patients, CRT has demonstrated to improve quality of life, promote reverse left ventricular (LV) remodeling, reduce HF hospitalizations, and extend survival. However, des-pite advancements in our understanding of CRT, a significant number of patients do not respond to this therapy. Several invas-ive and non-invasive parameters have been assessed to predict response to CRT, but the electrocardiogram (ECG) has remained as the prevailing screening method albeit with limitations. Ideally, an accurate, simple, and reproducible ECG marker or set of markers would dramatically overcome the current limitations. We describe the clinical utility of an old ECG parameter that can estimate ventricular activation delay: the onset to intrinsicoid deflection (ID). Based on the concept of direct measurement of ventricular activation time (intrinsic deflection onset), time to ID onset measures on the surface ECG the time that the electrical activation time takes to reach the area subtended by the corresponding surface ECG lead. Based on this principle, the time to ID on the lateral leads can estimate the delay activation to the lateral LV wall and can be used as a predictor for CRT response, par-ticularly in patients with non-specific intraventricular conduction delay or in patients with left bundle branch block and QRS <150 ms. The aim of this review is to present the current evidence and potential use of this ECG parameter to estimate LV activa-tion and predict CRT response.
机标关键词：synchronizationgraphictrocartimecardiacdeflectiondelayedintrinsicoid
论文发表日期：2022-01-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 21-30 )