Comparison between left bundle branch area pacing and right ventricular pacing: ventricular electromechanical synchrony and risk of atrial high-rate episodes.

Background: The electromechanical dyssynchrony associated with right ventricular pacing (RVP) has been found to have adverse impact on clinical outcomes. Several studies have shown that left bundle branch area pacing (LBBAP) has superior pacing parameters compared with RVP. We aimed to assess the difference in ventricular electromechanical synchrony and investigate the risk of atrial high-rate episodes (AHREs) in patients with LBBAP and RVP. Methods: We consecutively identified 40 patients with atrioventricular block and no prior atrial fibrillation. They were divided according to the ventricular pacing sites: the LBBAP group and the RVP group (including the right ventricular apical pacing (RVA) group and the right side ventricular septal pacing (RVS) group). Evaluation of ventricular electromechanical synchrony was implemented using electrocardiogram and two-dimensional speckle tracking echocardiography (2D-STE). AHRE was defined as event with an atrial frequency of ≥176 bpm lasting for ≥6 min recorded by pacemakers during follow-up. Results: The paced QRS duration of the LBBAP group was significantly shorter than that of the other two groups: LBBAP 113.56 ± 9.66 ms vs. RVA 164.73 ± 14.49 ms, p < 0.001; LBBAP 113.56 ± 9.66 ms vs. RVS 148.23 ± 17.3 ms, p < 0.001. The LBBAP group showed shorter maximum difference (TDmax), and standard deviation (SD) of the time to peak systolic strain among the 18 left ventricular segments, and time of septal-to-posterior wall motion delay (SPWMD) compared with the RVA group (TDmax, 87.56 ± 56.01 ms vs. 189.85 ± 91.88 ms, p = 0.001; SD, 25.40 ± 14.61 ms vs. 67.13 ± 27.40 ms, p < 0.001; SPWMD, 28.75 ± 21.89 ms vs. 99.09 ± 46.56 ms, p < 0.001) and the RVS group (TDmax, 87.56 ± 56.01 ms vs. 156.46 ± 55.54 ms, p = 0.003; SD, 25.40 ± 14.61 ms vs. 49.02 ± 17.85 ms, p = 0.001; SPWMD, 28.75 ± 21.89 ms vs. 91.54 ± 26.67 ms, p < 0.001). The interventricular mechanical delay (IVMD) was shorter in the LBBAP group compared with the RVA group (-5.38 ± 9.31 ms vs. 44.82 ± 16.42 ms, p < 0.001) and the RVS group (-5.38 ± 9.31 ms vs. 25.31 ± 21.36 ms, p < 0.001). Comparing the RVA group and the RVS group, the paced QRS duration and IVMD were significantly shorter in the RVS group (QRS duration, 164.73 ± 14.49 ms vs. 148.23 ± 17.3 ms, p = 0.02; IVMD, 44.82 ± 16.42 ms vs. 25.31 ± 21.36 ms, p = 0.022). During follow-up, 2/16 (12.5%) LBBAP patients, 4/11 (36.4%) RVA patients, and 8/13 (61.5%) RVS patients had recorded novel AHREs. LBBAP was proven to be independently associated with decreased risk of AHREs than RVP (log-rank p = 0.043). Conclusion: LBBAP generates narrower paced QRS and better intro-left ventricular and biventricular contraction synchronization compared with traditional RVP. LBBAP was associated with a decreased risk of AHREs compared with RVP.

Estilos de vida, adherencia a la dieta mediterránea, características antropométricas en un colectivo de universitarios de ciencias de la salud / Lifestyle, adherence to Mediterranean diet, anthropometric characteristics in a group of university health sciences students

Fundamentos: Los estudiantes universitarios viven importantes cambios de estilo de vida, patrón de adherencia a dieta mediterránea y estado nutricional. El objetivo de este estudio fue conocer las características de estos factores en universitarios valencianos y las asociaciones de estos entre sí. Métodos: Estudio descriptivo transversal en estudiantes universitarios de 18 a 27 años. Se evaluaron las características de estilos de vida, valores antropométricos, por género y edad, así como la asociación entre ellos mediante análisis descriptivo univariante y bivariante, incluyendo el test de U-Mann Whitney y la correlación de Spearman. Resultados: Entre los 682 estudiantes estudiados hay una baja prevalencia de obesidad (1,5%). Las mujeres presentan mayor nivel de consumo de tabaco (32,5%), mientras que los hombres muestran mayores frecuencias en la falta de desayuno (7,1%). Asimismo, el grupo de menores de 23 años destaca por una baja adherencia a la dieta mediterránea. Se observó una correlación positiva entre IMC, consumo de tabaco (p=0,001) y adherencia a la dieta mediterránea (p<0,0001). Existe correlación negativa entre IMC y frecuencia de desayuno (p=0,007), almuerzo (p=0,002) y merienda (p=0,006). Conclusiones: Los alumnos universitarios presentan mayoritariamente un IMC adecuado con baja prevalencia de obesidad. Existe margen de mejora en la adherencia a dieta mediterránea, en el hábito de desayuno y en los estilos de vida saludable (AU)

Background: University students are facing important changes of lifestyle, the pattern of adherence to Mediterranean Diet and nutritional status. The objective of this study was to know the characteristics of these factors implemented in university students of Valencia and their associations. Methods: A cross-sectional study on University students aged 18 to 27 years. We evaluated the characteristics of lifestyles and anthropometric values by gender and age and the association between them by univariate and bivariate analysis, including the Mann-Whitney U-test and Spearman correlations. Results: Of a total of 682 students we observed a low prevalence of obesity (1.5%). Women presented higher levels of tobacco consumption (32.5%), while men were more prone to skip breakfast showed higher frequencies in the lack of breakfast (7.1%). The younger age group (≤23) had a lower adherence to the Mediterranean diet. A positive correlation was observed between BMI, smoking (p=0.001) and adherence to the Mediterranean diet (p< 0.0001). There is also negative correlation between BMI and the frequency of breakfast (p=0.007), lunch (p=0.002) and snack (p=0.006). Conclusions: The university students present mainly a suitable BMI with a low prevalence of obesity. There is room for improvement in the adherence to a Mediterranean Diet, the habit of eating breakfast and healthy lifestyles (AU)