Multipoint pacing improves peripheral hemodynamic response: Noninvasive assessment using radial artery tonometry.
Abstract: Background: Multipoint left ventricular (LV) pacing (MultiPoint™ Pacing [MPP], Abbott, Sylmar, CA, USA) improves the response rate to cardiac resynchronization therapy (CRT). We evaluated the feasibility of noninvasive radial artery tonometry (RAT) to characterize arterial pressure morphol...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 41; no. 2; pp. 106 - 114 |
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| Autores principales: | , , , , , , , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Feb2018
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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=127991071&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 127991071 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Feb2018 vid: 41 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 127991071 127991071 127991071 10.1111/pace.13254 127991071 ppf: 106 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Multipoint pacing improves peripheral hemodynamic response: Noninvasive assessment using radial artery tonometry. aug: au: Ciconte, Giuseppe Ćalović, Žarko Vicedomini, Gabriele Cuko, Amarild McSpadden, Luke C. Jiang, Chunlan Ryu, Kyungmoo Caporaso, Igor Stutz, Robert Winter, Dean Saviano, Massimo Vitale, Raffaele Conti, Manuel Santinelli, Vincenzo Pappone, Carlo affil: Department of Arrhythmology, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy sug: subj: Tonometry Radial Artery Physiology Cardiac Resynchronization Therapy Cardiac Pacing, Artificial Arterial Pressure Intraoperative Period Noninvasive Procedures Human Postoperative Period Electrocardiography Male Female Descriptive Statistics Male Female ab: Abstract: Background: Multipoint left ventricular (LV) pacing (MultiPoint™ Pacing [MPP], Abbott, Sylmar, CA, USA) improves the response rate to cardiac resynchronization therapy (CRT). We evaluated the feasibility of noninvasive radial artery tonometry (RAT) to characterize arterial pressure morphology changes (pre‐ejection period [PEP] and ejection duration [ED]) between conventional CRT and MPP pacing interventions. Methods: Patients with a MPP‐enabled CRT device (Quadra Assura MP™, Abbott) underwent noninvasive RAT assessment (SphygmoCor CVMS, AtCor Medical Inc., Itasca, IL, USA) at 3–6 months after implantation. A pacing protocol was performed in a randomized order including one optimized conventional biventricular CRT (CONV) configuration using the distal electrode and five MPP configurations. The PEP, ED, and PEP/ED ratio were determined for each intervention from the RAT pressure waveform and electrocardiogram. Results: Pressure waveforms were successfully recorded in 19 patients (89% male, QRS 147 ± 16 ms, 63% ischemic). In 17/19 (89%) patients, at least one MPP intervention resulted in improved PEP, ED, and PEP/ED compared to CONV. The MPP intervention with greatest separation of LV cathodes and minimum intra‐LV delay significantly improved PEP (mean PEP –15 ± 33% vs –8 ± 32% [CONV], P = 0.04) and ED (mean ED +8 ± 8% [MPP] vs +4 ± 7% [CONV], P = 0.02), and PEP/ED (–0.07 ± 0.14 [MPP] vs –0.04 ± 0.13 [CONV], P = 0.02) compared with CONV. Conclusions: Noninvasive RAT efficiently characterizes changes in PEP and ED between CONV and MPP interventions. MPP configurations using the widest separation among LV cathodes and minimum intra‐LV delay may significantly improve RAT‐derived parameters as compared to conventional CRT. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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