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Cambios dinámicos de la onda S en el plomo V6: un nuevo indicador visual para la captura de la rama izquierda del haz
Shanshan Zhuo1, Longfu Jiang1, Xiaojie Cai1
1Department of Cardiology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China.
The Canadian journal of cardiology
|September 5, 2025
Resumen
La onda S en el V6 de plomo cambia dinámicamente, lo que indica la captura exitosa de la rama izquierda del haz durante la colocación del electrodo. Esta señal visual ayuda a lograr el ritmo selectivo de la rama izquierda (SLBBP).
Área de la Ciencia:
- Electrofisiología
- El ritmo cardíaco
- Cardiología
Sus antecedentes:
- El papel de la onda S en el V6 de plomo durante la inserción del electrodo de la rama izquierda (LBBP) no se entiende bien.
- La colocación precisa del plomo es crucial para la eficacia del LBBP y los resultados del paciente.
- Los métodos actuales para confirmar la posición de plomo pueden no capturar completamente los matices de los patrones de captura.
Objetivo del estudio:
- Para analizar los cambios en la morfología de la onda S en el plomo V6 durante diferentes patrones de captura de ritmo de la rama izquierda.
- Para investigar los mecanismos detrás de estos cambios de onda S.
- Para determinar el valor de diagnóstico de la onda S en el plomo V6 para la identificación de LBBP selectivo (SLBBP).
Principales métodos:
- Un estudio con 243 pacientes sometidos a PBL selectiva (PBLS).
- Se utilizaron técnicas de ritmo continuo para clasificar las características electrofisiológicas en cuatro patrones: ritmo septal ventricular izquierdo (LVSP), LBBP no selectivo (NSLBBP) a baja potencia, NSLBBP a baja potencia y SLBBP.
- Evaluación de la morfología de las ondas S en las ondas V6 y las horas pico de las ondas R en las ondas V6 y V1 en estos patrones.
Principales resultados:
- La presencia de una onda S en el plomo V6 aumentó progresivamente a través de los patrones: 35.4% (LVSP) a 97.9% (SLBBP).
- Se observó una profundización y emergencia significativas de la onda S a medida que el ritmo pasaba de LVSP a NSLBBP y luego a SLBBP.
- En SLBBP, la onda S en plomo V6 demostró una alta sensibilidad (97,9%) y especificidad (100%) para confirmar la captura.
Conclusiones:
- La onda S en V6 de plomo es un indicador dinámico que cambia de manera predecible con diferentes patrones de captura de la rama izquierda del haz.
- Una onda S que cambia dinámicamente en el V6 de plomo sirve como un nuevo marcador visual para la captura exitosa de la rama izquierda del haz.
- Este hallazgo puede mejorar la precisión y la eficiencia de la colocación de plomo durante los procedimientos selectivos de aceleración de la rama izquierda.
Palabras clave:
ritmo del sistema de conducciónTécnica de aceleración continuaCaptura de la rama del haz izquierdomorfología del QRS aceleradoel intervalo de fluidezMás Videos Relacionados
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