Background: Transcutaneous cardiac pacing (TCP) is deeply entwined with the problem of assessing ventricular capture on the electrocardiogram (ECG). We sought clarification of ventricular capture during TCP.
Methods: We studied one hundred and ten patients (75 ± 12 years) with bradycardia who underwent pacemaker or implantable cardioverter-defibrillator implantation. The cohort was stratified by structural heart disease (SHD) status and presence of narrow or wide QRS during spontaneous heart rhythm. We compared 12-lead ECG data at baseline (48 ± 7 beats/min) with those of TCP as well as of transvenous pacing (TVP) at a similar increased heart rate (76 ± 9 beats/min) to ensure constant ventricular capture. The QT interval was corrected for heart rate (QTc) using Bazett's method as well as by the Hodge's and Rautaharju's formulae depending on the presence of narrow or wide QRS at baseline. Electromechanical coupling was assessed by noninvasive arterial pressure measurement.
Results: TCP (median 80 mA) produced a QRS pattern resembling left bundle branch block. Overall, both TCP and TVP induced significant QRS and QTc prolongations when compared with baseline measures (p < 0.001). TCP created narrower QRS than TVP in those patients with SHD and narrow QRS (p < 0.006). There was no significant QTc duration difference between TCP and TVP. Mean arterial pressure underwent similar significant decrease following either TCP or TVP over baseline (p < 0.001), without difference between the two pacing approaches in any patient group.
Conclusion: TCP is associated with similar ECG and hemodynamic responses to those of TVP, regardless of the presence of SHD.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jelectrocard.2019.12.002 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Concurrent Micra Leadless Pacemaker Implantation and AVN Ablation: Computer Modeling of Novel Risk Mitigation Strategy.
Pacing Clin Electrophysiol
January 2025
Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin, USA.
Background: Concurrent Micra leadless pacemaker (Medtronic, Minneapolis, Minnesota) implantation and atrioventricular node (AVN) ablation has been shown to be feasible and safe in patients with symptomatic, drug-refractory atrial fibrillation (AF). However, major complications within the 30 days after concurrent Micra implantation and AVN ablation have been reported. We evaluated the efficacy and safety of the concurrent procedure at our institution.
View Article and Find Full Text PDFFailure of Automatic Capture Management in Left Bundle Branch Pacing.
Heart Rhythm
January 2025
Geisinger Heart Institute, Wilkes Barre, PA, USA. Electronic address:
Permanent Left Bundle Branch Area DF-4 Defibrillator Lead Implantation-Feasibility, Procedural Caveats, Safety, and Follow-Up.
J Cardiovasc Electrophysiol
January 2025
Department of Cardiac Electrophysiology and Pacing, Arrhythmia Heart Failure Academy, The Madras Medical Mission, Chennai, Tamil Nadu, India.
Introduction: Permanent implantation of a DF-4 implantable cardiac defibrillator (ICD) lead in the left bundle branch area (LBBA-ICD) is the next paradigm in amalgamating cardiac resynchronization therapy (CRT) and defibrillation. We systematically investigated feasibility/success rate, procedural caveats, and complications associated with a permanent DF-4 LBBA ICD implant and pertinent data at short-term follow-up.
Methods: We prospectively attempted implantation of 7 Fr Durata (Abbott, Chicago, IL, USA) single coil DF-4 ICD lead at the LBBA using a fixed-curve non-deflectable CPS locator delivery sheath.
[Clinical characteristics and pharmacological treatment of patients with heart failure in a primary health care cohort].
Aten Primaria
January 2025
Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, España; Institut Català de la Salut, Barcelona, España.
Objective: To characterise patients with heart failure (HF) in Primary Health Care (PHC) and describe their socio-demographic and clinical characteristics and pharmacological treatment.
Design: Descriptive cohort study. SITE: Information System for the Development of Research in Primary Care (SIDIAP), which captures information from the electronic health records of PHC of the Catalan Institute of Health (approximately 80% of the Catalan population).
Finerenone and new-onset diabetes in heart failure: a prespecified analysis of the FINEARTS-HF trial.
Lancet Diabetes Endocrinol
January 2025
British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. Electronic address:
Background: Data on the effect of mineralocorticoid receptor antagonist therapy on HbA levels and new-onset diabetes are conflicting. We aimed to examine the effect of oral finerenone, compared with placebo, on incident diabetes in the Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure (FINEARTS-HF) trial.
Methods: In this randomised, double-blind, placebo-controlled trial, 6001 participants with heart failure with New York Heart Association functional class II-IV, left ventricular ejection fraction 40% or higher, evidence of structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide levels were randomly assigned to finerenone or placebo, administered orally.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!