Villegas-Martinez Manuel, Krogh Magnus Reinsfelt, Andersen Øyvind S, Sletten Ole Jakob, Wajdan Ali, Odland Hans Henrik, Elle Ole Jakob, Remme Espen W
The Intervention Centre, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Front Physiol. 2022 Jun 2;13:903784. doi: 10.3389/fphys.2022.903784. eCollection 2022.
An abnormal systolic motion is frequently observed in patients with left bundle branch block (LBBB), and it has been proposed as a predictor of response to cardiac resynchronization therapy (CRT). Our goal was to investigate if this motion can be monitored with miniaturized sensors feasible for clinical use to identify response to CRT in real time. Motion sensors were attached to the septum and the left ventricular (LV) lateral wall of eighteen anesthetized dogs. Recordings were performed during baseline, after induction of LBBB, and during biventricular pacing. The abnormal contraction pattern in LBBB was quantified by the septal flash index (SFI) equal to the early systolic shortening of the LV septal-to-lateral wall diameter divided by the maximum shortening achieved during ejection. In baseline, with normal electrical activation, there was limited early-systolic shortening and SFI was low (9 ± 8%). After induction of LBBB, this shortening and the SFI significantly increased (88 ± 34%, < 0.001). Subsequently, CRT reduced it approximately back to baseline values (13 ± 13%, < 0.001 vs. LBBB). The study showed the feasibility of using miniaturized sensors for continuous monitoring of the abnormal systolic motion of the LV in LBBB and how such sensors can be used to assess response to pacing in real time to guide CRT implantation.
左束支传导阻滞（LBBB）患者常观察到异常的收缩期运动，并且它已被提议作为心脏再同步治疗（CRT）反应的预测指标。我们的目标是研究这种运动是否可以通过适用于临床的小型化传感器进行监测，以实时识别对CRT的反应。将运动传感器附着在18只麻醉犬的室间隔和左心室（LV）侧壁上。在基线期、诱发LBBB后以及双心室起搏期间进行记录。LBBB中的异常收缩模式通过间隔闪烁指数（SFI）进行量化，该指数等于左心室室间隔至侧壁直径的早期收缩期缩短量除以射血期间达到的最大缩短量。在基线期，电激活正常时，早期收缩期缩短有限，SFI较低（9±8%）。诱发LBBB后，这种缩短和SFI显著增加（88±34%，<0.001）。随后，CRT将其大致恢复到基线值（13±13%，与LBBB相比<0.001）。该研究表明了使用小型化传感器连续监测LBBB患者左心室异常收缩期运动的可行性，以及这种传感器如何用于实时评估起搏反应以指导CRT植入。
