Abstract：ObjectiveTo compare the electrocardiographic patterns recorded after left ventricular pacing from different coronary veins. MethodsWe selected 43 patients treated by cardiac resynchronization therapy(CRT). According to the target vessel of coronary vein in the implantation of left ventricular electrode, they were divided into five groups: lateral vein group(7 patients), posterior vein group(8 patients), posterolateral vein group(13 patients), great(anterior) vein group(8 patients) and middle cardiac vein group(7 patients). The unileftventricular pacing mode was set by programming controller after CRT. We recorded 12lead electrocardiograms(ECGs) during unileftventricular pacing, and measured and compared the ECG patterns among the five groups.ResultsAmong the 43 patients, right axis deviation was observed in 26(60.47%); 4 cases of left axis deviation were only found in middle cardiac vein group of which the axis distribution significantly varied from other groups. The incidences of Q wave in the initial segment of lead Ⅰ, R/S≤1 in lead Ⅰ and R/S≥1 in lead V1 were 79.07%, 83.72% and 67.44%, respectively while in middle cardiac vein group the incidences were only 42.86%, 42.86% and 28.57%, respectively. In posterolateral vein group, the incidence of R/S≤1 in lead Ⅰ was significantly higher than that in middle cardiac vein group(P=0.007). The QRS morphology patterns in inferior wall leads and lead V5，V6 did not vary significantly among different groups.ConclusionDifferent electrocardiographic patterns of left ventricular pacing correspond to different target vessels in the implantation of left ventricular electrode. The ECG patterns of left ventricular pacing from lateral vein, posterior vein, posterolateral vein and great(anterior) vein are similar, but the pattern of pacing from middle cardiac vein is quite different from those from other veins. The implantation site of left ventricular electrode should be paid extra attention in the diagnosis of left ventricular pacing.
2018, Vol. 27 
