Aims: Monitoring of haemodynamic parameters or surrogate parameters of the left ventricle is especially important for patients under cardiac resynchronization therapy (CRT). Intracardiac impedance reflects left ventricular (LV) volume changes well in animal models. Since it is unknown whether this also holds in humans with heart failure (HF), we examined the correlation of LV intracardiac impedance with haemodynamic parameters in CRT patients for different positions of the LV lead.
Methods And Results: In 14 HF patients with non-ischaemic cardiomyopathy (four female, age 70 +/- 6 years, NYHA 2.9 +/- 0.3, EF 26 +/- 6%), one or two suitable implantation sites for the LV lead were selected. Following atrial, right ventricular, and LV catheter positioning, a micro-manometer catheter was placed in the ascending aorta. Surface ECG, impedance, and aortic pressure were recorded during graded overdrive bi-ventricular pacing in DDD mode. The correlation between impedance and stroke volume (SV) or pulse pressure (PP) changes was compared for different LV lead positions. In total, 20 overdrive pacing tests were performed at six different LV lead positions. Strong correlations were found between stroke impedance (SZ) and SV (R = 0.82 +/- 0.16) as well as between SZ and PP (R = 0.81 +/- 0.16) without significant influence of LV lead position.
Conclusion: In HF patients, a strong correlation between changes in intracardiac impedance and LV SV was found. Typical LV lead implant positions have been tested and all appear to be suitable for this method of LV volume monitoring.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/europace/euq045 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Daily Measurements from Cardiac Implantable Electronic Devices to Assess Health Status.
Diagnostics (Basel)
December 2024
Department of Cardiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
Cardiac implantable electronic devices (CIEDs) such as pacemakers and implantable cardioverter-defibrillators (ICDs) are increasingly used in the aging population. Modern CIEDs perform daily measurements, mainly aimed at discovering early signs of battery depletion or electrode dysfunction. Changes in thresholds, intracardiac signals, and pacing impedances can be caused by exacerbation of existing conditions or novel clinical problems.
View Article and Find Full Text PDFElectrophysiological characteristics of lead position-dependent electrogram uninterrupted transition during left bundle branch pacing.
Heart Rhythm
November 2024
Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Guoke Ningbo Life Science and Health Industry Research Institute, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.
Background: The interrupted technique of left bundle branch pacing (LBBP) limits the continuous monitoring of paced electrocardiogram and intracardiac electrogram (EGM) transitions, which may result in overlooked or misinterpreted subtle transitions.
Objectives: This study aimed to explore the electrophysiological characteristics of lead position-dependent EGM continuous transitions to evaluate lead depth and to investigate the clinical significance of transseptal pacing modalities.
Methods: A continuous pacing and recording technique enabled by a rotatable connector was used to allow the real-time monitoring of progressive changes in paced EGM and electrocardiographic morphology.
Time-variant left ventricle models for intracardiac impedance analysis.
J Electr Bioimpedance
January 2024
Chair for Medical Information Technology, RWTH Aachen University, Aachen, Germany.
Cardiovascular diseases are a leading cause of mortality worldwide. Thus, critically ill patients require continuous monitoring of cardiovascular indicators, such as the left ventricular volume (LVV). Although continuous hemodynamic monitoring of patients is desirable, due to technical limitations, current measurement technologies either require manual intervention of the physician or only provide inaccurate results.
View Article and Find Full Text PDFChronic clinical performance of a novel subxiphoidal pacemaker system: Early feasibility study design.
Pacing Clin Electrophysiol
September 2024
Research & Development, Calyan Technologies, Saint Paul, Minnesota, USA.
Background: Extravascular and leadless pacemakers are a new class of cardiac devices that may reduce the rate of complications common to traditional cardiac pacemakers with intracardiac leads. These devices also have the potential of expanding access to cardiac pacing therapy by simplifying the complexity and cost of implantation. The objective of this study is to evaluate the implantation, chronic safety, and performance of a novel subxiphoidal pacemaker.
View Article and Find Full Text PDFClosed loop stimulation reduces the incidence of atrial high-rate episodes compared with conventional rate-adaptive pacing in patients with sinus node dysfunctions.
Europace
July 2024
ASST Rhodense, Rho & Garbagnate Hospitals, Viale Carlo Forlanini, 95, 20024 Garbagnate Milanese, Milan, Italy.
Article Synopsis
- Subclinical atrial fibrillation (AF) increases risks of developing clinical AF, stroke, and cardiovascular death; researchers aimed to test if closed loop stimulation (CLS) could reduce atrial high-rate episodes (AHREs) in pacemaker patients compared to conventional dual-chamber rate-adaptive pacing (DDDR).
- A study with 1,210 patients showed that those using CLS had a lower incidence of the primary endpoint (first AHRE lasting ≥6 min, stroke, or TIA) compared to DDDR over a 3-year period, particularly effective in patients without atrioventricular block or AF history.
- The findings suggest that dual-chamber CLS significantly reduces AHRE occurrence, highlighting its potential benefits for patients
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!