The Effect of Various Pacing Modes on Microvolt T-Wave Alternans in Patients Receiving Cardiac Resynchronization Therapy Kardiyak Resenkronizasyon Tedavisi Alan Hastalarda Çeşitli Kalp Pili Modlarının Mikrovolt T-Dalgası Alternansı Üzerindeki Etkisi

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Erciyes D., Gülbaran M., Yıldız C., Yazıcıoğlu N.

Medical Journal of Bakirkoy, cilt.22, sa.1, ss.84-90, 2026 (ESCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 22 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.4274/bmj.galenos.2025.2025.6-6
  • Dergi Adı: Medical Journal of Bakirkoy
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
  • Sayfa Sayıları: ss.84-90
  • Anahtar Kelimeler: Cardiac resynchronization, biventricular pacemaker, microvolt T-wave alternans
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: Microvolt T-wave alternans (MTWA) test is a non-invasive method for risk assessment before sudden cardiac death and malignant ventricular tachycardia. Cardiac resynchronization therapy (CRT) is effective in improving left ventricular (LV) systolic function and cardiac electrical activity. The present study investigates the effect of various pacemaker stimulation modes on MTWA in patients receiving CRT. Methods: The study included 35 patients who received CRT. MTWA was measured in LV, right ventricular (RV), biventricular (BV), and right atrial (RA) modes at 6±2 months after CRT implementation. MTWA results were classified as negative or non-negative. Positive and indeterminate results were considered non-negative. Continuous variables were expressed as mean±standard deviation, and Cohen’s kappa statistic was used to compare various pacing modes, with analyses conducted in SPSS at a significance level of p<0.05. Results: RA pacing was concordant with RV pacing in 27 (76.2%) patients (kappa=0.509; p=0.001); with LV pacing in 23 (65.7%) patients (kappa=0.263; p=0.094); and with BV pacing in 26 (74.3%) patients (kappa=0.463; p=0.003). The positive and negative predictive values of results obtained during RA pacing for predicting similar results obtained during RV pacing were 73.1% and 88.9%, respectively; for LV pacing, 65.4% and 66.7%, respectively; and for BV pacing, 69.2% and 88.9%, respectively. We did not find any differences in non-negative MTWA results across different pacing modes with respect to types of cardiomyopathies, statin or amiodarone treatment, and presence or absence of diabetes mellitus or hypertension. Conclusion: Similar results are achieved when comparing the MTWA results following RA, LV, RV, and BV pacemaker stimulations in patients receiving CRT.