BackgroundWith increasing use of cardiac resynchronization therapy (CRT), treating physicians should be familiar with different electrocardiographic (ECG) patterns of left ventricular (LV) lead and biventricular (BiV) pacing. However, there are a few publications on ECG patterns during BiV pacing.PurposeThis study was sought to determine different ECG patterns in patients with BiV pacing.MethodsTwelve-lead ECGs during BiV pacing (right ventricular leads at apex and LV leads in one of the lateral coronary veins) were analyzed in 181 consecutive patients (121 male; mean age, 62.0 ± 13.5 years) with advanced heart failure and baseline left bundle branch block pattern after at least 6-month of uncomplicated CRT.ResultsDuring BiV pacing, 65% of the patients showed a dominant R wave in V1. There was a right axis deviation in 57% in frontal plane. However, a left superior axis emerged in 34% and normal frontal plane axis in 9%. Sequential BiV pacing (73% vs. 58%, P = 0.04) and pacing from posterolateral coronary vein (80% vs. 60%, p = 0.045) were more likely to present with a dominant R wave in V1. In sequential pacing, AV interval was significantly longer in patients with negative complex in V1 than in those with positive complex (124 ± 21 vs. 116 ± 8.0, p = 0.005). A Q/q wave was detected in 85% of patients in lead I and 78% in lead aVL.ConclusionsBiV pacing from lateral coronary venous branches and right ventricular apex characteristically presented with dominant R wave in V1, Q/q wave in leads I and aVL, and right or left superior axis. However, a negative complex in V1, QRS axis in other quadrants, and lack of Q/q wave in leads I and aVL did not necessarily indicate a problem.

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‫دخول‬ ‫إعادة‬ ،)p=0.598 ‫%2.4؛‬ ‫مقابل‬ ‫األوعية‬ ‫تكوين‬ ‫وإعادة‬ ،)p=0.433 ‫%7.8)؛‬ ‫مقابل‬ 4.5%( ‫املستقرة‬ ‫غير‬ .)p=0.312 ‫%0؛‬ ‫مقابل‬ 2.2%( ‫التاجية‬ Objectives: To study the effects of low dose of empagliflozin on improving outcomes in diabetic patients with acute coronary syndrome )ACS( after percutaneous coronary intervention )PCI(. Methods: This double-blind controlled clinical trial was carried out on 93 diabetic patients )56 males and 37 females, mean age of 56.55 years( with ACS who underwent PCI at 2 university teaching hospitals in 2020, Ahvaz, Iran. The patients were randomly assigned to receive empagliflozin )10 mg once daily( or placebo at similar doses for 6 months after PCI. In addition, to standard treatments with another hypoglycemic agent. Cardiovascular outcomes )including all-cause mortality, coronary revascularization, rehospitalization due to unstable angina, hospitalization due to heart failure, Original Article cardiovascular death, non-fetal myocardial infarction, and non-fetal stroke( were evaluated during period of 6 months follow-up after the empagliflozin treatment. Results: There was no significant difference between the low dose empagliflozin and placebo groups after treatment in terms of cardiovascular mortality )2.2% versus [vs.] 4.2%; p=0.598(, rehospitalization due to unstable angina )4.5% vs. 8.7%; p=0.433(, and coronary revascularization )2.2% vs. 0%; p=0.312(. Conclusion:The results of this study showed that adding low dose empagliflozin to standard care of ACS diabetic patients after PCI was associated with no significant reduction in negative cardiovascular outcomes during 6 months.