Shen Jiabo, Jiang Longfu, Wu Hao, Li Hengdong, Zhang Lu, Zhong Jinyan, Zhuo Shanshan, Pan Lifang
Department of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.
Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.
Front Cardiovasc Med. 2023 Jan 11;9:1059172. doi: 10.3389/fcvm.2022.1059172. eCollection 2022.
The characteristics of discrete intracardiac electrogram (EGM) in selective left bundle branch (SLBB) pacing (SLBBP) have not been described in detail previously. This study aimed to examine the effect of different high-pass filter (HPF) settings on discrete local ventricular components in an intracardiac EGM and to analyze its possible mechanisms.
This study included 144 patients with indications of permanent cardiac pacing. EGMs were collected at four different HPF settings (30, 60, 100, and 200 Hz) with a low-pass filter at 500 Hz, and their possible mechanisms were analyzed.
LBBP was successfully achieved in 91.0% (131/144) of patients. SLBBP was achieved in 123 patients. The occurrence rates of discrete local ventricular EGM were 16.7, 33.3, 72.9, and 85.4% for HPF settings of 30, 60, 100, and 200 Hz, respectively. The analysis of discrete EGM detection showed significant differences between the different HPF settings. By using the discrete local ventricular component and isoelectric interval as the SLBB capture golden standard, the results of EGMs revealed that the 30 Hz HPF has a sensitivity of 19% and specificity of 100%. The 60 Hz HPF had a sensitivity of 39% and a specificity of 100%. The 100 Hz HPF had a sensitivity of 85% and a specificity of 100%. The 200 Hz HPF had a sensitivity of 100% and specificity of 100%.
An optimal HPF setting of 200 Hz is recommended for discrete local ventricular EGM detection. A discrete local ventricular EGM should exhibit an isoelectric interval. A steep deflection and high-frequency ventricular EGM morphology nearly identify an intrinsic EGM morphology.
选择性左束支起搏（SLBBP）时离散的心内心电图（EGM）特征此前尚未得到详细描述。本研究旨在探讨不同高通滤波器（HPF）设置对心内心电图中离散的局部心室成分的影响，并分析其可能机制。
本研究纳入144例有永久性心脏起搏指征的患者。在低通滤波器设置为500Hz的情况下，于四种不同的HPF设置（30、60、100和200Hz）下采集EGM，并分析其可能机制。
91.0%（131/144）的患者成功实现左束支起搏（LBBP）。123例患者实现了SLBBP。HPF设置为30、60、100和200Hz时，离散的局部心室EGM发生率分别为16.7%、33.3%、72.9%和85.4%。离散EGM检测分析显示不同HPF设置之间存在显著差异。以离散的局部心室成分和等电位间期作为SLBB捕捉的金标准，EGM结果显示30Hz HPF的灵敏度为19%，特异性为100%。60Hz HPF的灵敏度为39%，特异性为100%。100Hz HPF的灵敏度为85%，特异性为100%。200Hz HPF的灵敏度为100%，特异性为100%。
对于离散的局部心室EGM检测，建议最佳HPF设置为200Hz
