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Reversible T-wave inversions during left bundle branch area pacing

Jie Geng1, Zhixin Jiang1, Shigeng Zhang1, Xiujuan Zhou1, Yuanyuan Chen1, Meng Chen1, Chongchong Chen1, Qijun Shan1
DOI: 10.33963/KP.a2022.0167
·
Pubmed: 35836370
Affiliations
  1. Department of Cardiology, 1st Affiliated Hospital of Nanjing Medical University, Nanjing, China

open access

Online first
Original article
Published online: 2022-07-15

Abstract

BACKGROUND: Our clinical observation found T-wave inversions (TWIs) appeared during left bundle branch area pacing (LBBAP), however, the incidence and influence factors were unclear. To investigate the effects of LBBAP on T-wave and explore possible factors associated with TWIs.

METHODS: This was a retrospective cohort study. Electrocardiogram (ECG) was acquired at baseline and after LBBAP. Baseline characteristics, ECG parameters, LBBAP parameters and troponin T (TNT) levels were compared between non-TWIs and TWIs groups. Multivariable logistic analyses were performed to adjust for potential confounders to identify the predictive factors of TWIs during LBBAP.

RESULTS: A total of 398 consecutive patients underwent successful LBBAP were assessed for inclusion between May 2017 and Jan 2021, and 264 (66.3%) patients had TWIs. The mean (standard deviation [SD]) baseline QRS duration (QRSd) was longer in TWIs group compared to non-TWIs group (125.9 [34.5] ms vs. 98.2 [18.1] ms; P <0.001). Multivariable logistic regression analysis suggested that QRSd >120 ms was an independent predictor for TWIs. TWIs were partially or completely recovered in 151/172 (87.8%) patients during follow-up, the median (interquartile range [IQR]), follow-up duration was 10 days (7 days to 5.5 months). TWIs in patients with complete left bundle branch block (CLBBB) occured more frequency in inferior wall leads (II, III and aVF) and anterior wall leads (V1-4) (P <0.05, respectively). Patients with complete right bundle branch block (CRBBB) were more prone to TWIs in high lateral wall leads (I and aVL) (P <0.05, respectively). There were no significant differences of TNT levels between TWIs and non-TWIs groups.

CONCLUSIONS: TWIs during LBBAP was clinically frequent can recoverable. QRSd >120 ms was independently associated with TWIs.

Abstract

BACKGROUND: Our clinical observation found T-wave inversions (TWIs) appeared during left bundle branch area pacing (LBBAP), however, the incidence and influence factors were unclear. To investigate the effects of LBBAP on T-wave and explore possible factors associated with TWIs.

METHODS: This was a retrospective cohort study. Electrocardiogram (ECG) was acquired at baseline and after LBBAP. Baseline characteristics, ECG parameters, LBBAP parameters and troponin T (TNT) levels were compared between non-TWIs and TWIs groups. Multivariable logistic analyses were performed to adjust for potential confounders to identify the predictive factors of TWIs during LBBAP.

RESULTS: A total of 398 consecutive patients underwent successful LBBAP were assessed for inclusion between May 2017 and Jan 2021, and 264 (66.3%) patients had TWIs. The mean (standard deviation [SD]) baseline QRS duration (QRSd) was longer in TWIs group compared to non-TWIs group (125.9 [34.5] ms vs. 98.2 [18.1] ms; P <0.001). Multivariable logistic regression analysis suggested that QRSd >120 ms was an independent predictor for TWIs. TWIs were partially or completely recovered in 151/172 (87.8%) patients during follow-up, the median (interquartile range [IQR]), follow-up duration was 10 days (7 days to 5.5 months). TWIs in patients with complete left bundle branch block (CLBBB) occured more frequency in inferior wall leads (II, III and aVF) and anterior wall leads (V1-4) (P <0.05, respectively). Patients with complete right bundle branch block (CRBBB) were more prone to TWIs in high lateral wall leads (I and aVL) (P <0.05, respectively). There were no significant differences of TNT levels between TWIs and non-TWIs groups.

CONCLUSIONS: TWIs during LBBAP was clinically frequent can recoverable. QRSd >120 ms was independently associated with TWIs.

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Keywords

T-wave inversions, cardiac memory, left bundle branch area pacing, complete left bundle branch block, complete right bundle branch block

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Title

Reversible T-wave inversions during left bundle branch area pacing

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-07-15

Page views

80

Article views/downloads

41

DOI

10.33963/KP.a2022.0167

Pubmed

35836370

Keywords

T-wave inversions
cardiac memory
left bundle branch area pacing
complete left bundle branch block
complete right bundle branch block

Authors

Jie Geng
Zhixin Jiang
Shigeng Zhang
Xiujuan Zhou
Yuanyuan Chen
Meng Chen
Chongchong Chen
Qijun Shan

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