Continuous right ventricular volume assessment by catheter measurement of impedance for antitachycardia system control.
Current implantable defibrillators are unable to differentiate between hemodynamically stable and unstable arrhythmias. This may result in unnecessary high energy shocks during arrhythmias that are better managed with other interventions. This study assessed the efficacy of the impedance catheter in...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 12; no. 12; pp. 1918 - 1927 |
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| Autores principales: | , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
Dec1989
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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=106087208&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106087208 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Dec1989 vid: 12 iid: 12 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106087208 2009413596 NLM2481290 106087208 ppf: 1918 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Continuous right ventricular volume assessment by catheter measurement of impedance for antitachycardia system control. aug: au: Khoury D Mcalister H Wilkoff B Simmons T Rudy Y Mcgowan R Morant V Castle L Maloney J sug: subj: Cardioversion Methods Prostheses and Implants Stroke Volume Tachycardia Physiopathology Adult Aged Algorithms Cardioversion Equipment and Supplies Electrocardiography Methods Female Heart Catheterization Heart Ventricle Hemodynamics Male Middle Age Tachycardia Therapy Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Current implantable defibrillators are unable to differentiate between hemodynamically stable and unstable arrhythmias. This may result in unnecessary high energy shocks during arrhythmias that are better managed with other interventions. This study assessed the efficacy of the impedance catheter in sensing relative volumetric changes in the right ventricle as a measure of the hemodynamic status during an arrhythmia. During electrophysiological testing, 37 arrhythmias were induced in 12 patients aged 28-74 years. Rhythms recorded were: (A) hemodynamically stable tachyarrhythmias (supraventricular tachycardia and sustained monomorphic ventricular tachycardia) - 21 episodes; and (B) hemodynamically unstable ventricular arrhythmias causing syncope (hypotensive ventricular tachycardia and ventricular fibrillation) - 16 episodes. During unstable arrhythmias, stroke impedance (32 ± 17%), arterial systolic pressure (40 ± 11%), and right ventricular pulse pressure (15 ± 20%), expressed as percentages of corresponding sinus rhythm values, were significantly lower than in stable arrhythmias (84 ± 26%, 72 ± 8%, and 111 ± 37%, respectively); P < 0.001. There was a good correlation between stroke impedance and mean arterial pressure during arrhythmia (r = 0.84). Impedance sensing is a practical method for distinguishing between hemodynamically stable and unstable arrhythmias. Implementation of hemodynamic sensing into the algorithm of future antitachycardia systems may improve the management of arrhythmias by adding options for selective pace termination or cardioversion. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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