Clinical symptoms of limited exercise capacity linked to AAI‐DDD functionality: An in silico and in vivo approach.
Background: Exercise capacity is an important aspect of quality of life in patients undergoing pacemaker implantation. Device algorithms for ventricular pacing avoidance have been developed to avoid unnecessary and potentially harmful effects of right ventricular pacing. However, little data exists...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 44; no. 5; pp. 943 - 952 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | pictorial research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
May2021
|
| 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=150206248&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 150206248 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: May2021 vid: 44 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 150206248 149898643 150206248 150206248 10.1111/pace.14239 150206248 ppf: 943 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Clinical symptoms of limited exercise capacity linked to AAI‐DDD functionality: An in silico and in vivo approach. aug: au: Heggermont, Ward Iliodromitis, Konstantinos Van Bockstal, Koen Backers, Jos Lau, Chirik‐Wah Missiaen, Dieter De Cooman, Jan Timmermans, Willy Geelen, Peter De Potter, Tom affil: Cardiovascular Research Center, Onze‐Lieve‐Vrouw Hospital Aalst, Moorselbaan 164, Aalst B‐9300,, Belgium sug: subj: Exercise Functional Status Cardiac Pacing, Artificial Human Algorithms In Vivo Studies Computer Simulation Arteriovenous Malformations ab: Background: Exercise capacity is an important aspect of quality of life in patients undergoing pacemaker implantation. Device algorithms for ventricular pacing avoidance have been developed to avoid unnecessary and potentially harmful effects of right ventricular pacing. However, little data exists on the immediate response of these algorithms to sudden AV block during exercise. Methods: The ventricular pacing avoidance algorithms of four pacemaker manufacturers were tested in an ex‐vivo model. The RSIM‐1500‐USB Device‐Interactive Heart Simulator (Rivertek Medical Systems, Inc.) was used to simulate three different scenarios: the first one starting with an initially conducted atrial pacing rate of 60 min−1, the second one starting with an atrial rate of 120 min−1 and finally a scenario starting with an atrial rate of 150 min−1. In all three scenarios, the initially conducted atrial rate was followed by a sudden, long lasting episode of third‐degree AV‐block. The response to those scenarios was recorded for each of the (brand‐specific) ventricular pacing avoidance algorithms. Results: In the first scenario, the simulation resulted in a ventricular pause of 1333 ms (Boston Scientific), 2000 ms (Medtronic and Microport), and 2340 ms (Biotronik). In the second and third scenario, different results were observed across devices. All simulations of the second and third scenario resulted in repetitive 2:1 block response (during eight cycles) in Boston Scientific and Biotronik devices. These scenarios were confirmed in patient cases. Conclusion: Simulator based observations of unanticipated pacemaker‐induced 2:1 block response during exercise may explain clinical symptoms experienced by some patients having a two‐chamber pacemaker. pubtype: Academic Journal doctype: pictorial research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|