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Giornale Italiano di Cardiologia Pratica - It J Practice Cardiol Dicembre 2007-Marzo 2008
si passa a esaminare la derivazione D1; se in D1 il rapporto
R/S è 1 la cattura non avviene. Infatti nella risincronizzazione
con cattura del ventricolo sinistro il vettore
elettrico principale è diretto verso V1 con una morfologia
tipo blocco di branca destra, anche se, considerando
il concomitante pacing dall’apice del ventricolo
destro o il blocco di branca sinistra di base, è raro
avere una immagine da blocco di branca destra completo.
In D1 l’attivazione del ventricolo sinistro determina
una deflessione prevalentemente negativa poiché
il vettore principale è diretto da sinistra a destra e
si allontana da D1.
La sensibilità di questo algoritmo nell’identificare la
mancata cattura del ventricolo sinistro è 94%; la specificità
è 93%; il likelihood ratio della risposta positiva
è 12.8; il likelihood negativo è 0.06.
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