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Verfasst von:Wiedmann, Felix Tobias [VerfasserIn]   i
 Jamros, Max [VerfasserIn]   i
 Herlt, Valerie [VerfasserIn]   i
 Paasche, Amelie [VerfasserIn]   i
 Kraft, Manuel [VerfasserIn]   i
 Beck, Moritz [VerfasserIn]   i
 Prüser, Merten [VerfasserIn]   i
 Erkal, Atilla [VerfasserIn]   i
 Harder, Maren [VerfasserIn]   i
 Zaradzki, Marcin [VerfasserIn]   i
 Soethoff, Jasmin [VerfasserIn]   i
 Karck, Matthias [VerfasserIn]   i
 Frey, Norbert [VerfasserIn]   i
 Schmidt, Constanze [VerfasserIn]   i
Titel:A porcine large animal model of radiofrequency ablation-induced left bundle branch block
Verf.angabe:Felix Wiedmann, Max Jamros, Valerie Herlt, Amelie Paasche, Manuel Kraft, Moritz Beck, Merten Prüser, Atilla Erkal, Maren Harder, Marcin Zaradzki, Jasmin Soethoff, Matthias Karck, Norbert Frey and Constanze Schmidt
E-Jahr:2024
Jahr:19 April 2024
Umfang:14 S.
Illustrationen:Illustrationen
Fussnoten:Gesehen am 28.05.2024
Titel Quelle:Enthalten in: Frontiers in physiology
Ort Quelle:Lausanne : Frontiers Research Foundation, 2007
Jahr Quelle:2024
Band/Heft Quelle:15(2024) vom: Apr., Artikel-ID 1385277, Seite 1-14
ISSN Quelle:1664-042X
Abstract:<sec><title>Background</title><p>Electrocardiographic (ECG) features of left bundle branch (LBB) block (LBBB) can be observed in up to 20%-30% of patients suffering from heart failure with reduced ejection fraction. However, predicting which LBBB patients will benefit from cardiac resynchronization therapy (CRT) or conduction system pacing remains challenging. This study aimed to establish a translational model of LBBB to enhance our understanding of its pathophysiology and improve therapeutic approaches.</p></sec><sec><title>Methods</title><p>Fourteen male pigs underwent radiofrequency catheter ablation of the proximal LBB under fluoroscopy and ECG guidance. Comprehensive clinical assessments (12-lead ECG, bloodsampling, echocardiography, electroanatomical mapping) were conducted before LBBB induction, after 7, and 21 days. Three pigs received CRT pacemakers 7 days after LBB ablation to assess resynchronization feasibility.</p></sec><sec><title>Results</title><p>Following proximal LBB ablation, ECGs displayed characteristic LBBB features, including QRS widening, slurring in left lateral leads, and QRS axis changes. QRS duration increased from 64.2 ± 4.2 ms to 86.6 ± 12.1 ms, and R wave peak time in V6 extended from 21.3 ± 3.6 ms to 45.7 ± 12.6 ms. Echocardiography confirmed cardiac electromechanical dyssynchrony, with septal flash appearance, prolonged septal-to-posterior-wall motion delay, and extended ventricular electromechanical delays. Electroanatomical mapping revealed a left ventricular breakthrough site shift and significantly prolonged left ventricular activation times. RF-induced LBBB persisted for 3 weeks. CRT reduced QRS duration to 75.9 ± 8.6 ms, demonstrating successful resynchronization.</p></sec><sec><title>Conclusion</title><p>This porcine model accurately replicates the electrical and electromechanical characteristics of LBBB observed in patients. It provides a practical, cost-effective, and reproducible platform to investigate molecular and translational aspects of cardiac electromechanical dyssynchrony in a controlled and clinically relevant setting.</p></sec>
DOI:doi:10.3389/fphys.2024.1385277
URL:kostenfrei: Volltext: https://doi.org/10.3389/fphys.2024.1385277
 kostenfrei: Volltext: https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2024.1385277/full
 DOI: https://doi.org/10.3389/fphys.2024.1385277
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:alanine aminotransferase
 alkaline phosphatase
 ALT
 AP
 aspartate aminotransferase
 AST
 atrial effective refractory period
 atrioventricular node effective refractory period
 AVNERP
 C-reactive protein
 cardiac resynchronization therapy
 Cardiac resynchronization therapy
 cardiac resynchronization therapy pacemaker
 conduction system pacing
 CRP
 CRT
 CRT-P
 CSP
 large animal model
 LBBB
 Left bundle branch block AERP
K10plus-PPN:1890140600
Verknüpfungen:→ Zeitschrift
 
 
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