Effects of transcutaneous cardiac pacing on ventricular repolarization and comparison with transvenous pacing

• Published in: Pacing and clinical electrophysiology 2020-09, Vol.43 (9), p.1004-1011
• Main Authors: Zagkli, Fani, Georgakopoulou, Alexandra, Chiladakis, John
• Format: Article
• Language: English
• Subjects: Bradycardia; Coronary artery disease; Depolarization; EKG; electrocardiogram; Heart diseases; Heart rate; Pacemakers; Potassium; resuscitation; transcutaneous cardiac pacing; transvenous pacing; Ventricle; ventricular repolarization
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.14000

Background The electrocardiographic (ECG) effects of transcutaneous cardiac pacing (TCP) on ventricular repolarization have not been studied in detail. This study evaluated the influence of TCP on ventricular repolarization. The results were compared with those obtained by conventional transvenous right ventricular pacing (TVP). Methods Sixty‐two patients with spontaneous bradycardia and standard indication for pacemaker or implantable cardioverter‐defibrillator implantation were enrolled. Patients were divided into two groups based on the presence or not of structural heart disease (SHD). Surface 12‐lead ECG characteristics of ventricular depolarization (QRS complex) and repolarization (QT and JT intervals, Tpeak to Tend interval [TpTe], QT dispersion [QTd], TpTe dispersion [TpTe‐d], and TpTe/QT ratio) were recorded at baseline before device implantation (45 ± 5 beats/min) and were compared with corresponding data during short periods of TCP and TVP at a similar increased heart rate (81 ± 6 beats/min). Results Both TCP and TVP compared with baseline measures significantly increased the QRS complex and the QTc/JTc intervals regardless of SHD status (P