{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:07:29Z","timestamp":1792789649689,"version":"4.5.0"},"reference-count":81,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002996","name":"Dutch Heart Foundation","doi-asserted-by":"publisher","award":["2021T016"],"award-info":[{"award-number":["2021T016"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Dutch Heart Foundation","doi-asserted-by":"publisher","award":["NU21-02-00584"],"award-info":[{"award-number":["NU21-02-00584"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Health of the Czech Republic","award":["2021T016"],"award-info":[{"award-number":["2021T016"]}]},{"name":"Ministry of Health of the Czech Republic","award":["NU21-02-00584"],"award-info":[{"award-number":["NU21-02-00584"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Identifying electrical dyssynchrony is crucial for cardiac pacing and cardiac resynchronization therapy (CRT). The ultra-high-frequency electrocardiography (UHF-ECG) technique allows instantaneous dyssynchrony analyses with real-time visualization. This review explores the physiological background of higher frequencies in ventricular conduction and the translational evolution of UHF-ECG in cardiac pacing and CRT. Although high-frequency components were studied half a century ago, their exploration in the dyssynchrony context is rare. UHF-ECG records ECG signals from eight precordial leads over multiple beats in time. After initial conceptual studies, the implementation of an instant visualization of ventricular activation led to clinical implementation with minimal patient burden. UHF-ECG aids patient selection in biventricular CRT and evaluates ventricular activation during various forms of conduction system pacing (CSP). UHF-ECG ventricular electrical dyssynchrony has been associated with clinical outcomes in a large retrospective CRT cohort and has been used to study the electrophysiological differences between CSP methods, including His bundle pacing, left bundle branch (area) pacing, left ventricular septal pacing and conventional biventricular pacing. UHF-ECG can potentially be used to determine a tailored resynchronization approach (CRT through biventricular pacing or CSP) based on the electrical substrate (true LBBB vs. non-specified intraventricular conduction delay with more distal left ventricular conduction disease), for the optimization of CRT and holds promise beyond CRT for the risk stratification of ventricular arrhythmias.<\/jats:p>","DOI":"10.3390\/jcdd11030076","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T10:47:30Z","timestamp":1708685250000},"page":"76","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Ultra-High-Frequency ECG in Cardiac Pacing and Cardiac Resynchronization Therapy: From Technical Concept to Clinical Application"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4836-2946","authenticated-orcid":false,"given":"Uy\u00ean Ch\u00e2u","family":"Nguy\u00ean","sequence":"first","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"},{"name":"Department of Physiology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5136-4830","authenticated-orcid":false,"given":"Jesse H. J.","family":"Rijks","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2875-3541","authenticated-orcid":false,"given":"Filip","family":"Plesinger","sequence":"additional","affiliation":[{"name":"Institute of Scientific Instruments of the Czech Academy of Sciences, 61200 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6106-7354","authenticated-orcid":false,"given":"Leonard M.","family":"Rademakers","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Catharina Ziekenhuis, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Luermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin C.","family":"Smits","sequence":"additional","affiliation":[{"name":"Department of Physiology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonius M. W.","family":"van Stipdonk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frits W.","family":"Prinzen","sequence":"additional","affiliation":[{"name":"Department of Physiology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-5964","authenticated-orcid":false,"given":"Kevin","family":"Vernooy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8986-796X","authenticated-orcid":false,"given":"Josef","family":"Halamek","sequence":"additional","affiliation":[{"name":"Institute of Scientific Instruments of the Czech Academy of Sciences, 61200 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3523-6358","authenticated-orcid":false,"given":"Karol","family":"Curila","sequence":"additional","affiliation":[{"name":"Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Srobarova, 1150\/50, 10034 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavel","family":"Jurak","sequence":"additional","affiliation":[{"name":"Institute of Scientific Instruments of the Czech Academy of Sciences, 61200 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/europace\/euab232","article-title":"2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"24","author":"Glikson","year":"2022","journal-title":"Europace"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1056\/NEJMoa0906431","article-title":"Cardiac-resynchronization therapy for the prevention of heart-failure events","volume":"361","author":"Moss","year":"2009","journal-title":"N. 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