Acute Clinical Evaluation of a Left Ventricular Automatic Threshold Determination Algorithm Based on Evoked Response Sensing.

Introduction: Automatic pacing threshold (AT) testing may simplify device follow-up and improve device longevity. This study's objective was to evaluate the performance of a left ventricular (LV) evoked response sensing-based AT algorithm, for cardiac resynchronization therapy (CRT) devices. Methods...

Descripción completa

Detalles Bibliográficos
Publicado en:Pacing & Clinical Electrophysiology Vol. 35; no. 3; pp. 348 - 357
Autores principales: Kalahasty, Gautham, Giudici, Michael, Lobban, John, Doshi, Rahul, Delaney, Colleen, Shome, Shibaji, Gold, Michael R., Ellenbogen, Kenneth
Formato: clinical trial research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Mar2012
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104527948&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 104527948
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        01478389
        4F8
      jtl: Pacing & Clinical Electrophysiology
      issn: 01478389
      maglogo: Y
    pubinfo:
      dt: Mar2012
      vid: 35
      iid: 3
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        104527948
        72416726
        10.1111/j.1540-8159.2011.03287.x
        NLM22150299
        104527948
      ppf: 348
      ppct: 9
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Acute Clinical Evaluation of a Left Ventricular Automatic Threshold Determination Algorithm Based on Evoked Response Sensing.
      aug:
        au:
          Kalahasty, Gautham
          Giudici, Michael
          Lobban, John
          Doshi, Rahul
          Delaney, Colleen
          Shome, Shibaji
          Gold, Michael R.
          Ellenbogen, Kenneth
        affil: Virginia Commonwealth University, Richmond, Virginia
      sug:
        subj:
          Evoked Potentials
          Heart Ventricle
          Rehabilitation, Cardiac
          Cardiac Pacing, Artificial
          Algorithms
          Human
          Multicenter Studies
          Clinical Trials
          Descriptive Statistics
          Fisher's Exact Test
          Electrocardiography
          United States
          Male
          Female
          Aged
          Aged, 80 and Over
          Data Analysis Software
          Confidence Intervals
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Introduction: Automatic pacing threshold (AT) testing may simplify device follow-up and improve device longevity. This study's objective was to evaluate the performance of a left ventricular (LV) evoked response sensing-based AT algorithm, for cardiac resynchronization therapy (CRT) devices. Methods: Patients scheduled for CRT-D/P implant were enrolled. A manual step-down threshold test and a Left Ventricular Automatic Threshold (LVAT) test in each of four pacing vectors-LVTip→Can, LVTip→right ventricle (RV), = LVRing→Can, and LVRing→RV-were conducted. Patients were randomized to either 0.4-ms or 1.0-ms pacing pulse width and in the manual and LVAT test order. A blinded core lab electrophysiologist (EP) determined the threshold using the surface electrocardiogram (gold standard). Results: Data from 70 patients were analyzed. Bipolar LV leads from three major manufacturers were used. A total of 273 AT tests were performed; 12 AT tests did not result in a threshold due to improper testing conditions. Of 261 eligible tests, 234 AT tests (89.6%) returned a threshold measurement. Of the 234 tests, in 233 tests (99.5%) the algorithm-determined threshold matched the EP-determined threshold for that test. A total of 16,689 capture and 526 noncapture beats were collected and the accuracy for detecting capture and noncapture were 98.5% and 99.7% with a two-sided 95% confidence level of (98.4%, 98.7%) and (99.4%, 100%), respectively. No AT threshold measurement was lower than the EP-determined threshold. Conclusion: In this study, the results suggest that the LVAT algorithm is accurate at determining pacing thresholds in multiple pacing configurations and a wide range of LV leads in CRT-D/P patients. (PACE 2011;1-5)
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N