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Focused transesophageal left atrial and left ventricular pacing with different pacing mode for supraventricular tachycardia initiation and cardiac resynchronization therapy simulation

  • Capture threshold (CT) for transesophageal left atrial (LA) pacing (TLAP) and transesophageal left ventricular (LV) pacing (TLVP) with conventional cylindrical electrodes (CE) are higher than TLAP feeling threshold (FT). Purpose of the study was to evaluate focused TLAP CT and FT for supraventricular tachycardia (SVT) initiation and focused TLVP CT for cardiac resynchronisation therapy (CRT)Capture threshold (CT) for transesophageal left atrial (LA) pacing (TLAP) and transesophageal left ventricular (LV) pacing (TLVP) with conventional cylindrical electrodes (CE) are higher than TLAP feeling threshold (FT). Purpose of the study was to evaluate focused TLAP CT and FT for supraventricular tachycardia (SVT) initiation and focused TLVP CT for cardiac resynchronisation therapy (CRT) simulation. Methods: SVT initiation in patients (P) with palpitations (n=49, age 47 ± 17 years) was analysed during spontaneous rhythm and during focused bipolar TLAP with atrial constant current stimulus output, distal CE and three or seven 6 mm hemispherical electrodes (HE) (TO, Osypka AG, Rheinfelden, Germany). CRT simulation in heart failure P (n=75, age 62 ± 11 years) was evaluated by focused bipolar TLAP and/or TLVP with ventricular constant voltage stimulus output and different pacing mode. Results: Focused electrical pacing field between CE and HE (n=28) allowed low threshold TLAP with 8.0 ± 2.6 mA CT at 9.9 ms stimulus duration (SD) which was lower than 9.2 ± 4.5 mA FT at 9.9 ms SD. Focused electrical pacing field between HE and HE (n=21) allowed low threshold TLAP with 8.1 ± 2.2 mA CT at 9.9 ms SD which was lower than 9.8 ± 5.0 mA FT at 9.9 ms SD. SVT initiation by programmed AAI TLAP was possible in 23 P and not possible in 26 P. CRT simulation was evaluated with TLAP and TLVP with VAT, D00 and V00 pacing mode and 95.5 ± 10.9 V TLVP CT at 4.0 ms SD. Conclusions: Programmed focused AAI TLAP allowed initiation of SVT with very low CT and high FT and focused electrical pacing field between CE-HE and HE-HE.CRT simulation with focused TLAP and/or TLVP with VAT, D00 and V00 pacing mode may be a useful technique to detect responders to CRT.show moreshow less

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Metadaten
Author:Matthias HeinkeGND, Bruno IsmerGND, Helmut Kühnert, Juraj Melichercik, Tobias Heinke, Ralf Surber, Gudrun Dannberg, Dirk Prochnau, Hans Reiner Figulla
Publisher:Walter de Gruyter
Place of publication:Berlin, Boston
Date of Publication (online):2012/09/06
Language:English
Parent Title (Multiple languages):Biomedizinische Technik / Biomedical Engineering
Volume:57
Issue:SI-1 Track-Q
ISSN:0013-5585 (Print)
ISSN:1862-278X (Online)
First Page:375
Last Page:378
Document Type:Conference Proceeding
Institutes:Hochschule Offenburg / Bibliografie
Release Date:2015/06/12
Licence (German):License LogoEs gilt das UrhG
Note:
Proceedings BMT 2012, 46. DGBMT Jahrestagung, Jena - Track Q. Personalized Medical Technology, 16.-19.09.2012
DOI:https://doi.org/10.1515/bmt-2012-4033