Related Experiment Video
Updated: Jul 3, 2026
10:17
Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
Measurement of QRS duration for biventricular pacing optimization
Catherine M Albright1, T Alexander Quinn, George Berberian
1Department of Surgery, Columbia University, New York, New York 10032, USA.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|July 23, 2008
Summary
QRS duration (QRSd) offers a rapid, noninvasive method for optimizing biventricular pacing (BiVP). This study found QRSd narrowing correlated with improved cardiac function, suggesting its potential for clinical BiVP adjustments.
Area of Science:
- Cardiology
- Biomedical Engineering
- Physiology
Background:
- Biventricular pacing (BiVP) efficacy relies on optimal site and delay settings.
- Current Cardiac Output (CO) optimization is invasive and time-consuming.
- QRS duration (QRSd) is a noninvasive, rapid indicator of ventricular synchrony.
Purpose of the Study:
- To evaluate the utility of QRSd for optimizing BiVP in a model of acute right ventricular (RV) pressure overload.
- To compare QRSd changes with Cardiac Output (CO) and ventricular function during BiVP adjustments.
- To assess the speed of QRSd response to BiVP reprogramming.
Main Methods:
- Anesthetized open-chest pigs with induced heart block and RV pressure overload.
- Fifty-four combinations of left ventricular (LV) pacing sites and interventricular delays tested.
- Measurements included QRSd, CO, and ventricular function; Pearson's correlation (r) used for analysis.
Main Results:
- QRSd narrowing correlated with improved RV function and transseptal synchrony.
- Correlation between QRSd and CO was poor.
- QRSd stabilization occurred within seven cardiac cycles post-reprogramming, with r-values exceeding 0.90.
Conclusions:
- QRSd is a sensitive, rapid, noninvasive marker for BiVP optimization.
- QRSd-based optimization shows promise for clinical application in heart failure patients.
- Further investigation of QRSd for BiVP optimization in patients is warranted.
Related Concept Videos
01:13Special considerations while measuring pulse
Assessing a patient's pulse is a fundamental skill in healthcare, but certain situations require special attention:
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
01:30Dysrhythmias V: Evaluating Dysrhythmias
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
01:29Electrocardiogram
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
01:28Electrocardiogram Fundamentals
Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin to...
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin to...
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...