Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.
Faculty of Medicine, Masaryk University, Brno, Czech Republic.
PLoS One. 2020 Feb 19;15(2):e0228731. doi: 10.1371/journal.pone.0228731. eCollection 2020.
Differences in conduction times from right ventricle to left ventricle and from left ventricle to right ventricle respectively were observed during biventricular devices implantation when changing pacing vector direction. In this article the phenomenon of interventricular conduction time differences is described and assessed in relationship to various clinical and electrophysiological parameters.
In 62 consecutive patients (9 females) interventricular conduction times between right and left ventricle in both directions were measured during cardiac resynchronization therapy device implantation procedure. Complex pacing protocol was performed.
Investigated individuals was divided into 3 subgroups according to type of interventricular conduction pattern and statistically tested with various clinical data. Substantial differences in right-to-left vs left-to-right conduction times (> 5 ms, range 7-72 ms) were observed in 24 (39%) of all patients. They were more common in patients with dilated cardiomyopathy (20 of 38, 53%) compared to 4 (17%) of 24 patients with coronary artery disease (p = 0.011). The phenomenon occurred more often in hypertensive patients (p = 0.012). Other tested factors were nonsignificant.
There are almost no data on this topic. The occurrence of conduction difference phenomenon is quite common in dilated cardiomyopathy while it is rare in coronary artery disease. We assume the diffuse nature of the disease and the way of remodeling of myocardium play the main role. Knowledge of this phenomenon could be useful in personalized cardiac resynchronization therapy optimization.
在双心室装置植入过程中改变起搏向量方向时，观察到右心室到左心室和左心室到右心室的传导时间分别存在差异。本文描述了这种室间传导时间差异的现象，并评估了其与各种临床和电生理参数的关系。
在 62 例连续患者（9 名女性）中，在心脏再同步治疗装置植入过程中测量了双向心室的右心室和左心室之间的室间传导时间。进行了复杂的起搏方案。
根据室间传导模式的类型将研究对象分为 3 个亚组，并与各种临床数据进行统计学检验。在所有患者中，有 24 例（39%）观察到右向左与左向右传导时间的显著差异（>5ms，范围 7-72ms）。与 24 例冠心病患者（17%）相比，扩张型心肌病患者中更常见（20/38，53%）（p=0.011）。该现象在高血压患者中更为常见（p=0.012）。其他测试因素无显著性差异。
关于这个主题几乎没有数据。在扩张型心肌病中，传导差异现象的发生相当常见，而在冠心病中则很少见。我们假设疾病的弥漫性和心肌重塑的方式起主要作用。了解这一现象可能有助于个性化心脏再同步治疗的优化。
