title: Effects of cardiac resynchronization therapy on ventricular repolarization in patients with congestive heart failure.
abstract: BACKGROUND
  Biventricular pacing has been shown to improve the clinical status of patients with congestive heart failure, but little is known about its influence on ventricular repolarization. The aim of our study was to evaluate the effect of biventricular pacing on ECG markers of ventricular repolarization in patients with congestive heart failure.
  
  
  RESULTS
  Twenty-five patients with congestive heart failure, sinus rhythm (SR), and complete LBBB (6 females; age 61 +/- 8 years; NYHA class II-III; echocardiographic ejection fraction 21 +/- 5%; QRS > or = 130 ms) underwent permanent biventricular DDDR pacemaker implantation. A high-resolution 65-lead body-surface ECG recording was performed at baseline and during right-, left-, and biventricular pacing, and the total 65-lead root mean square curve of the QRST complex and the interlead QT dispersion were assessed. The QRS duration was increased during right (RV)- and left ventricular (LV) pacing (127 +/- 26% and 117 +/- 40%; P < 0.05), as compared to SR (100%) and biventricular pacing (93 +/- 16%; ns). The QTc interval was increased during RV and LV pacing (112 +/- 12% and 114 +/- 14%; P < 0.05) as compared to SR (100%) or biventricular pacing (99 +/- 12%). There was no effect on JT interval during all pacing modes. The T(peak-end) interval was increased during right (120 +/- 34%; P < 0.01) and LV pacing (113 +/- 29%; P < 0.05) but decreased during biventricular pacing (81 +/- 19%; P < 0.01). A similar effect was found for the T(peak-end) integral and the T(peak) amplitude. QT dispersion was increased during right ventricular (129 +/- 16 ms; P < 0.05) and decreased during biventricular pacing (90 +/- 12 ms; P < 0.01), as compared to SR (114 +/- 22 ms).
  
  
  CONCLUSIONS
  Using a high-resolution surface ECG, biventricular pacing resulted in a significant reduction of ECG markers of ventricular dispersion of repolarization.
authors.affiliation: Innsbruck Medical University, Clinical Division of Cardiology, A-6020 Innsbruck, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Berger
authors.forename: Friedrich
authors.initials: F
authors.lastname: Hanser
authors.forename: Florian
authors.initials: F
authors.lastname: Hintringer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Poelzl
authors.forename: Gerald
authors.initials: G
authors.lastname: Fischer
authors.forename: Robert
authors.initials: R
authors.lastname: Modre
authors.forename: Bernhard
authors.initials: B
authors.lastname: Tilg
authors.forename: Otmar
authors.initials: O
authors.lastname: Pachinger
authors.forename: Franz X
authors.initials: FX
authors.lastname: Roithinger
mesh_terms: D000368:Aged; D018780:Body Surface Potential Mapping; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D018754:Ventricular Dysfunction / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology