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Slow wall motion rather than electrical conduction delay underlies mechanical dyssynchrony in postinfarction patients with narrow QRS complex

Standard

Slow wall motion rather than electrical conduction delay underlies mechanical dyssynchrony in postinfarction patients with narrow QRS complex. / Klemm, Hanno U; Krause, Korff T; Ventura, Rodolfo; Schneider, Carsten; Aydin, Muhammat A; Johnsen, Christin; Boczor, Sigrid; Meinertz, Thomas; Morillo, Carlos A; Kuck, Karl-Heinz.

In: J CARDIOVASC ELECTR, Vol. 21, No. 1, 01.2010, p. 70-77.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Klemm, HU, Krause, KT, Ventura, R, Schneider, C, Aydin, MA, Johnsen, C, Boczor, S, Meinertz, T, Morillo, CA & Kuck, K-H 2010, 'Slow wall motion rather than electrical conduction delay underlies mechanical dyssynchrony in postinfarction patients with narrow QRS complex', J CARDIOVASC ELECTR, vol. 21, no. 1, pp. 70-77. https://doi.org/10.1111/j.1540-8167.2009.01579.x

APA

Klemm, H. U., Krause, K. T., Ventura, R., Schneider, C., Aydin, M. A., Johnsen, C., Boczor, S., Meinertz, T., Morillo, C. A., & Kuck, K-H. (2010). Slow wall motion rather than electrical conduction delay underlies mechanical dyssynchrony in postinfarction patients with narrow QRS complex. J CARDIOVASC ELECTR, 21(1), 70-77. https://doi.org/10.1111/j.1540-8167.2009.01579.x

Vancouver

Klemm HU, Krause KT, Ventura R, Schneider C, Aydin MA, Johnsen C et al. Slow wall motion rather than electrical conduction delay underlies mechanical dyssynchrony in postinfarction patients with narrow QRS complex. J CARDIOVASC ELECTR. 2010 Jan;21(1):70-77. https://doi.org/10.1111/j.1540-8167.2009.01579.x

Bibtex

@article{c172610bedf046cda071ca333ccc8a2e,
title = "Slow wall motion rather than electrical conduction delay underlies mechanical dyssynchrony in postinfarction patients with narrow QRS complex",
abstract = "INTRODUCTION: The mechanism of mechanical dyssynchrony in postinfarction patients with a narrow QRS complex is not defined but essential for cardiac resynchronization therapy (CRT).METHODS AND RESULTS: Left ventricular electrical activation and subsequent wall motion were recorded for 16 patients with ischemic cardiomyopathy during intrinsic rhythm using a modified NOGA electromechanical mapping system. Ten patients presented mechanical dyssynchrony on tissue Doppler imaging, while 6 patients served as control subjects. The local activation time (LAT) was set by the maximum downslope of the unipolar electrogram. Local wall motion time (LMT) was defined as the time needed for the catheter tip to traverse half of its maximum inward deflection during systole. LAT and LMT were measured relative to the onset of the QRS complex. Electrical activation showed a septal-to-lateral pattern in all patients with a mean endocardial activation time of 65 +/- 13 ms. Control subjects exhibited 97.5% of all LMTs <290 +/- 17 ms. Delayed motion areas (cut-off LMT > 300 ms) showed no slowing of conduction. Wall motion time corrected for differences in electrical activation (LMT-LAT) was significantly longer in delayed (289 +/- 34 ms) than in regular (204 +/- 24 ms) motion areas (P = 0.002). Delayed motion segments were hypokinetic on echocardiography and presented a lower maximum inward motion (9.9 +/- 1.1 mm) compared to regular segments (10.9 +/- 1.2 mm) on electromechanical maps (P = 0.004). Viability, however, was preserved with unipolar and bipolar voltage amplitude >7 mV and >1.5 mV for 79% of all delayed motion areas.CONCLUSION: Dyssynchronous segments of an ischemic myocardium show unimpaired local activation but slow wall motion, thereby limiting the benefit of ventricular preexcitation via CRT.",
keywords = "Arrhythmias, Cardiac/complications, Body Surface Potential Mapping/methods, Electrocardiography/methods, Female, Humans, Male, Middle Aged, Myocardial Infarction/complications, Reproducibility of Results, Ventricular Dysfunction, Left/diagnosis",
author = "Klemm, {Hanno U} and Krause, {Korff T} and Rodolfo Ventura and Carsten Schneider and Aydin, {Muhammat A} and Christin Johnsen and Sigrid Boczor and Thomas Meinertz and Morillo, {Carlos A} and Karl-Heinz Kuck",
year = "2010",
month = jan,
doi = "10.1111/j.1540-8167.2009.01579.x",
language = "English",
volume = "21",
pages = "70--77",
journal = "J CARDIOVASC ELECTR",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "1",

}

RIS

TY - JOUR

T1 - Slow wall motion rather than electrical conduction delay underlies mechanical dyssynchrony in postinfarction patients with narrow QRS complex

AU - Klemm, Hanno U

AU - Krause, Korff T

AU - Ventura, Rodolfo

AU - Schneider, Carsten

AU - Aydin, Muhammat A

AU - Johnsen, Christin

AU - Boczor, Sigrid

AU - Meinertz, Thomas

AU - Morillo, Carlos A

AU - Kuck, Karl-Heinz

PY - 2010/1

Y1 - 2010/1

N2 - INTRODUCTION: The mechanism of mechanical dyssynchrony in postinfarction patients with a narrow QRS complex is not defined but essential for cardiac resynchronization therapy (CRT).METHODS AND RESULTS: Left ventricular electrical activation and subsequent wall motion were recorded for 16 patients with ischemic cardiomyopathy during intrinsic rhythm using a modified NOGA electromechanical mapping system. Ten patients presented mechanical dyssynchrony on tissue Doppler imaging, while 6 patients served as control subjects. The local activation time (LAT) was set by the maximum downslope of the unipolar electrogram. Local wall motion time (LMT) was defined as the time needed for the catheter tip to traverse half of its maximum inward deflection during systole. LAT and LMT were measured relative to the onset of the QRS complex. Electrical activation showed a septal-to-lateral pattern in all patients with a mean endocardial activation time of 65 +/- 13 ms. Control subjects exhibited 97.5% of all LMTs <290 +/- 17 ms. Delayed motion areas (cut-off LMT > 300 ms) showed no slowing of conduction. Wall motion time corrected for differences in electrical activation (LMT-LAT) was significantly longer in delayed (289 +/- 34 ms) than in regular (204 +/- 24 ms) motion areas (P = 0.002). Delayed motion segments were hypokinetic on echocardiography and presented a lower maximum inward motion (9.9 +/- 1.1 mm) compared to regular segments (10.9 +/- 1.2 mm) on electromechanical maps (P = 0.004). Viability, however, was preserved with unipolar and bipolar voltage amplitude >7 mV and >1.5 mV for 79% of all delayed motion areas.CONCLUSION: Dyssynchronous segments of an ischemic myocardium show unimpaired local activation but slow wall motion, thereby limiting the benefit of ventricular preexcitation via CRT.

AB - INTRODUCTION: The mechanism of mechanical dyssynchrony in postinfarction patients with a narrow QRS complex is not defined but essential for cardiac resynchronization therapy (CRT).METHODS AND RESULTS: Left ventricular electrical activation and subsequent wall motion were recorded for 16 patients with ischemic cardiomyopathy during intrinsic rhythm using a modified NOGA electromechanical mapping system. Ten patients presented mechanical dyssynchrony on tissue Doppler imaging, while 6 patients served as control subjects. The local activation time (LAT) was set by the maximum downslope of the unipolar electrogram. Local wall motion time (LMT) was defined as the time needed for the catheter tip to traverse half of its maximum inward deflection during systole. LAT and LMT were measured relative to the onset of the QRS complex. Electrical activation showed a septal-to-lateral pattern in all patients with a mean endocardial activation time of 65 +/- 13 ms. Control subjects exhibited 97.5% of all LMTs <290 +/- 17 ms. Delayed motion areas (cut-off LMT > 300 ms) showed no slowing of conduction. Wall motion time corrected for differences in electrical activation (LMT-LAT) was significantly longer in delayed (289 +/- 34 ms) than in regular (204 +/- 24 ms) motion areas (P = 0.002). Delayed motion segments were hypokinetic on echocardiography and presented a lower maximum inward motion (9.9 +/- 1.1 mm) compared to regular segments (10.9 +/- 1.2 mm) on electromechanical maps (P = 0.004). Viability, however, was preserved with unipolar and bipolar voltage amplitude >7 mV and >1.5 mV for 79% of all delayed motion areas.CONCLUSION: Dyssynchronous segments of an ischemic myocardium show unimpaired local activation but slow wall motion, thereby limiting the benefit of ventricular preexcitation via CRT.

KW - Arrhythmias, Cardiac/complications

KW - Body Surface Potential Mapping/methods

KW - Electrocardiography/methods

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/complications

KW - Reproducibility of Results

KW - Ventricular Dysfunction, Left/diagnosis

U2 - 10.1111/j.1540-8167.2009.01579.x

DO - 10.1111/j.1540-8167.2009.01579.x

M3 - SCORING: Journal article

C2 - 19732235

VL - 21

SP - 70

EP - 77

JO - J CARDIOVASC ELECTR

JF - J CARDIOVASC ELECTR

SN - 1045-3873

IS - 1

ER -