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Cambios en la repolarización electrocardiográfica tras el marcapasos de conducción del sistema en la miocardiopatía
Ahmet Taha Sahin1, Ugur Canpolat2, Muhammet Dural3
1Department of Cardiology, Necmettin Erbakan University Hospital, Meram, Konya, Turkiye.
Journal of electrocardiology
|January 30, 2026
Resumen
El marcapasos del área de la rama izquierda (LBBAP) no muestra efectos adversos en la repolarización en pacientes con miocardiopatía inducida por marcapasos (PICM). Esta estrategia de marcapasos fisiológica es segura y comparable a los controles de miocardiopatía dilatada (DCM).
Área de la Ciencia:
- Cardiología
- Electrofisiología
- Dispositivos Médicos
Sus antecedentes:
- La miocardiopatía inducida por marcapasos (PICM) resulta de la estimulación crónica del ventrículo derecho (RVP) que causa disfunción ventricular izquierda.
- El marcapasos del área de la rama izquierda (LBBAP) es una estrategia de marcapasos fisiológica que puede revertir la PICM.
- Los efectos agudos de LBBAP sobre la repolarización ventricular en PICM no se comprenden bien.
Objetivo del estudio:
- Evaluar los cambios inmediatos en la repolarización después de LBBAP en pacientes con PICM.
- Comparar las respuestas de repolarización en pacientes con PICM sometidos a LBBAP con un grupo de control de pacientes con miocardiopatía dilatada no isquémica (DCM).
Principales métodos:
- Análisis retrospectivo de datos clínicos, electrocardiográficos y de marcapasos de pacientes que recibieron LBBAP exitoso.
- Medición manual de intervalos de ECG basales y posteriores a la implantación (QT, QTc, Tp-Te) y evaluación cualitativa de la memoria de onda T (TWM).
- Registro de parámetros del procedimiento, tasas de éxito y complicaciones.
Principales resultados:
- Se incluyeron sesenta pacientes (28 PICM, 32 DCM); la FEVI basal fue mayor en PICM.
- Las tasas de éxito de LBBAP fueron similares entre los grupos (93 % vs. 96 %).
- Los pacientes con PICM tuvieron un QRS estimulado más ancho y intervalos V6-V1 más largos, pero las métricas de repolarización (QT, QTc, Tp-Te, TWM) no mostraron cambios adversos y fueron comparables a los controles de DCM.
Conclusiones:
- LBBAP no induce cambios desfavorables agudos en la repolarización en PICM.
- Las respuestas de repolarización después de LBBAP en PICM son comparables a las de los pacientes con DCM.
- LBBAP apoya la seguridad y demuestra un beneficio fisiológico para las actualizaciones de PICM.
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