Physical activity detection in patients with intracardiac leadless pacemaker.

Introduction: The Micra Transcatheter Pacing System provides a rate adaptive pacing using an individually programmable three‐axis accelerometer. We evaluated the short‐ and mid‐term performance of the Micra activity sensor by testing all three available activity vectors during the exercise tests. Me...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 29; no. 12; pp. 1690 - 1697
Autores principales: Bari, Zsolt, Vamos, Mate, Bogyi, Peter, Reynolds, Dwight, Sheldon, Todd, Fagan, Dedra H., Duray, Gabor Zoltan
Formato: algorithm pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2018
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jce.13729
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        atl: Physical activity detection in patients with intracardiac leadless pacemaker.
      aug:
        au:
          Bari, Zsolt
          Vamos, Mate
          Bogyi, Peter
          Reynolds, Dwight
          Sheldon, Todd
          Fagan, Dedra H.
          Duray, Gabor Zoltan
        affil: Department of Cardiology, Medical Centre, Hungarian Defence Forces, Budapest Hungary
      sug:
        subj:
          Pacemaker, Artificial Methods
          Physical Activity Evaluation
          Exercise Test
          Human
          Prospective Studies
          Office Visits
          Accelerometers
      ab: Introduction: The Micra Transcatheter Pacing System provides a rate adaptive pacing using an individually programmable three‐axis accelerometer. We evaluated the short‐ and mid‐term performance of the Micra activity sensor by testing all three available activity vectors during the exercise tests. Methods and Results: Implantation and follow‐up data were prospectively collected from the patients undergoing Micra implantation at our institution. Patients underwent a 5‐minute exercise test for each vector at predischarge (initial testing) and at scheduled in‐office visits (repeat testing). On the basis of measurements of activity counts during the test, vectors were categorized to be adequate (excellent or acceptable) or poor. A total of 278 tests with 818 vector measurements were analyzed in 51 patients during follow‐up (median duration was 18 months). Initial testing revealed the adequate quality of the nominal Vector 1 in 74.5% of the patients. Upon repeated testing at subsequent in‐office visits, Vectors 1 and 3 were comparable (adequate quality in 64.7% vs 68.6% of the patients; P = 0.65) but better compared with Vector 2 (51.0%; P = 0.10 vs Vector 1, P = 0.01 vs Vector 3). In a subgroup of 45 patients programmed to VVIR mode, Vector 1 was selected in 46.7% of the patients after the initial test (Vector 2, 8.9%; Vector 3, 44.4%). Vector change was performed in 10 patients (22.2%) following repeated tests within 3 months of postimplantation. Conclusion: The three‐axis accelerometer‐based rate adaptive pacing feature proved to be feasible after manual selection of an adequate activity vector. Vector testing in Micra patients with chronotropic incompetence appears to be beneficial compared with the use of nominal Vector 1.
      pubtype: Academic Journal
      doctype:
        algorithm
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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