Open AccessOptimization of Repolarization during Biventricular Pacing: A New Target in Patients with Biventricular Devices?
Author(s) -
Türkoğlu Cengizhan,
Aliyev Farid,
Çeliker Cengiz,
Çetin Gökhan,
Alici Gökhan,
Uzunhasan Işil,
Firatli Inci
Publication year - 2010
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/j.1542-474x.2009.00337.x
Subject(s) - medicine , cardiology , repolarization , cardiac resynchronization therapy , ventricular fibrillation , qt interval , qrs complex , amiodarone , heart failure , atrial fibrillation , ejection fraction , electrophysiology
Background: Evaluation of repolarization during sequentional biventricular pacing. Methods: Patients with biventricular devices, and left ventricular leads placed to the basal part of lateral left ventricular wall were enrolled. QRS, QTc, JTc, and corrected Tpeak‐Tend intervals were compared during sequentional biventricular, left ventricular, and right ventricular pacing. Results: Five patients with nonischemic and five with ischemic cardiomyopathy due to anterior myocardial infarction were enrolled. No correlation was observed between values of repolarization among patients. The optimal values of repolarization were significantly different from values of echocardiographically guided hemodynamic optimization. Two patients with biventricular pacing‐induced ventricular fibrillation were successfully treated by reprogramming of V‐V delay according to interventricular delay resulting in shorter Tpeak‐Tend interval, although delayed effect of amiodarone in one of these patients cannot be ruled out. Conclusions: Patients with biventricular devices may be prone to development of ventricular arrhythmias depending on programmed V‐V interval. We suggest that optimization of repolarization may be performed in patients with biventricular pacemakers in the absence of backup ICD and those with frequent episodes of ventricular tachyarrhythmias, although this finding deserves further study. Ann Noninvasive Electrocardiol 2010;15(1):36–42