Validation of a peak endocardial acceleration-based algorithm to optimize cardiac resynchronization: early clinical results.
Aims: Cardiac resynchronization therapy (CRT) involves time-consuming procedures to achieve an optimal programming of the system, at implant as well as during follow-up, when remodelling occurs. A device equipped with an implantable sensor able to measure peak endocardial acceleration (PEA) has been...
| Publicado en: | EP: Europace Vol. 10; no. 7; pp. 801 - 809 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Oxford University Press / USA
Jul2008
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| 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=105659382&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105659382 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10995129 NYF jtl: EP: Europace issn: 10995129 maglogo: N pubinfo: dt: Jul2008 vid: 10 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 105659382 NLM18492682 2009957706 10.1093/europace/eun125 NLM18492682 105659382 ppf: 801 ppct: 8 formats: tig: atl: Validation of a peak endocardial acceleration-based algorithm to optimize cardiac resynchronization: early clinical results. aug: au: Delnoy PP Marcelli E Oudeluttikhuis H Nicastia D Renesto F Cercenelli L Plicchi G Delnoy, Peter Paul Marcelli, Emanuela Oudeluttikhuis, Henk Nicastia, Deborah Renesto, Fabrizio Cercenelli, Laura Plicchi, Gianni affil: Isala Klinieken, Heart Lung Centre, Zwolle, The Netherlands sug: subj: Algorithms Cardiac Resynchronization Therapy Methods Endocardium Physiopathology Models, Biological Aged Aged, 80 and Over Electrocardiography Female Heart Conduction System Physiopathology Male Middle Age Pacemaker, Artificial Time Factors Ventricular Dysfunction, Left Physiopathology Ventricular Dysfunction, Left Therapy Human Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Aims: Cardiac resynchronization therapy (CRT) involves time-consuming procedures to achieve an optimal programming of the system, at implant as well as during follow-up, when remodelling occurs. A device equipped with an implantable sensor able to measure peak endocardial acceleration (PEA) has been recently developed to monitor cardiac function and to guide CRT programming. During scanning of the atrioventricular delay (AVD), PEA reflects both left ventricle (LV) contractility (LV dP/dt(max)) and transmitral flow. A new CRT optimization algorithm, based on recording of PEA (PEA(area) method) was developed, and compared with measurements of LV dP/dt(max), to identify an optimal CRT configuration.Methods and Results: We studied 15 patients in New York Heart Association classes II-IV and with a QRS duration >130 ms, who had undergone implantation of a biventricular (BiV) pulse generator connected to a right ventricular (RV) PEA sensor. At a mean of 39 +/- 15 days after implantation of the CRT system, the patients underwent cardiac catheterization. During single-chamber LV or during BiV stimulation, with initial RV or LV stimulation, and at settings of interventricular intervals between 0 and 40 ms, the AVD was scanned between 60 and 220 ms, while LV dP/dt(max) and PEA were measured. The area of PEA curve (PEA(area) method) was estimated as the average of PEA values measured during AVD scanning. A >or=10% increase in LV dP/dt(max) was observed in 12 of 15 patients (80%), who were classified as responders to CRT. In nine of 12 responders (75%), the optimal pacing configuration identified by the PEA(area) method was associated with the greatest LV dP/dt(max).Conclusion: The concordance of the PEA(area) method with measurements of LV dP/dt(max) suggests that this new, operator-independent algorithm is a reliable means of CRT optimization. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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