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Articles in PresS, published online ahead of print May 23, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00051.2002
Submitted on January 22, 2002
Accepted on May 16, 2002
1 Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
* To whom correspondence should be addressed. E-mail: x.verbeek{at}fys.unimaas.nl.
The quantification of mechanical interventricular asynchrony (IVA) was investigated. In 12 dogs left bundle branch block (LBBB) was induced by radio frequency ablation. Left (LV) and right ventricular (RV) pressures were recorded before and after induction of LBBB and during LBBB+LV apex pacing at different atrioventricular (AV) delays. Four IVA measures were validated using computer simulations on experimentally obtained pressure signals. The most robust measure for IVA was the time delay between the upslope of the LV and RV pressure signals (
Tup), estimated by cross correlation. Induction of experimental LBBB decreased Tup from -6.9±7.0 ms (RV before LV) to -33.9±7.6 ms (P<0.05) in combination with a significant decrease of LV dP/dt|max. During LV apex pacing, Tup increased with decreasing AV-delay up to +20.9±14.6 ms (P<0.05). Interventricular resynchronization (Tup=0 ms) significantly improved LV dP/dt|max by 15.1±5.9%. QRS duration increased significantly after induction of LBBB but did not change during LV apex pacing. Conclusion: Tup is a reliable measure of mechanical IVA, which adds valuable information concerning the nature of asynchronous activation of the ventricles.
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