Effect of Cardiac Resynchronization Therapy on Ventricular Repolarization Parameters and Ventricular Arrhythmias

Yıl 2022, , 363 - 369, 30.09.2022

Mohammed Abusharekh , Muhammad Hamayun Kakar Emin Evren Özcan

https://doi.org/10.34087/cbusbed.1029286

Öz

Objective: Cardiac resynchronization therapy (CRT) is commonly used in patients with heart failure (HF) along with left ventricular mechanic and electrical dyssencrony. Left ventricular epicardial pacing in CRT patients changes the normal myocardial activation and increases the transmural dispersion of repolarization. We aimed to investigate the impact of CRT on repolarization parameters and reveal its consequences on arrhythmic events.
Materials and Methods: The study consisted of 54 patients treated with CRT. Repolarization parameters; QT, T peak-to-T end and JT, Tpe/QT, QT dispersion and Tpe dispersion were measured. The patients were also investigated in two subgroups according to the presence of ventricular arrhythmias at the end of follow-up. Subgroups were compared in terms of repolarization parameters.
Results The change in repolarization parameters according to baseline values were also compared in the whole group.In the whole study group, all of the repolarization parameters significantly increased in the acute phase. In the chronic phase, these abnormalities were significantly diminished. The comparison of the two subgroups did not show any significant difference in respect of repolarization parameters.
Conclusion: Epicardial pacing prolongs myocardial repolarization time and increases transmural dispersion of repolarization. However, these abnormalities were transient and were not associated with ventricular arrhythmias.

Anahtar Kelimeler

Cardiac resynchronization therapy, New repolarization parameters, Heart failure

Kardiyak Resenkronizasyon Tedavisinin Ventriküler Repolarizasyon Parametreleri ve Ventriküler Aritmiler Üzerindeki Etkisi

Öz

Giriş ve Amaç: Kardiyak re senkronizasyon tedavisi (KRT), sol ventrikül mekanik ve elektriksel dissenkronisi olan kalp yetmezliği (KY) hastalarında yaygın olarak kullanılmaktadır. KRT hastalarında sol ventrikül epikardiyal pacing, normal miyokardiyal aktivasyonu değiştirir ve repolarizasyonun transmural dağılımını arttırmaktadır. KRT'nin repolarizasyon parametreleri üzerindeki etkisini araştırmayı ve aritmik olaylar üzerindeki sonuçlarını ortaya çıkarmayı amaçladık.
Gereç ve Yöntemler: Çalışma, KRT ile tedavi edilen 54 hastadan oluşmaktaydı. Repolarizasyon parametreleri; QT, T tepeden T sonuna geçen süre (Tpe), JT, Tpe/QT, QT dispersiyonu ve Tpe disperisyonu ölçüldü. Hastalar ayrıca takip sonundaki ventriküler aritmi varlığına göre iki alt grupta incelendi. Alt gruplar repolarizasyon parametreleri açısından karşılaştırıldı. Başlangıç değerlerine göre repolarizasyon parametrelerinin değişimi de tüm grupta karşılaştırıldı.
Bulgular: Tüm çalışma grubunda akut fazda repolarizasyon parametrelerinin tamamı anlamlı olarak artmıştır. Kronik fazda, bu anormallikler önemli ölçüde azalmıştır. İki alt grubun karşılaştırılmasında ise repolarizasyon parametreleri açısından anlamlı bir fark saptanmamıştır.
Sonuç: Epikardiyal pacing, miyokardiyal repolarizasyon süresini uzatmakta ve repolarizasyonun transmural dağılımını arttırmaktadır. Ancak bu anormallikler geçici olup ventriküler aritmilerle ilişkili bulunmamıştır.

Anahtar Kelimeler

Kardiyak resenkronizasyon tedavisi, Yeni repolarizasyon parametreleri, Kalp yetmezliği

Kaynakça

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