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Novel telemetric signal averaging ECG approach to determine electrical atrial and ventricular conduction delays in implantable cardioverter defibrillator patients

  • Cardiac resynchronization therapy (CRT) with biventricular pacing is an established therapy for heart failure (HF) patients (P) with ventricular desynchronization and reduced left ventricular (LV) ejection fraction. The aim of this study was to evaluate electrical right atrial (RA), left atrial (LA), right ventricular (RV) and LV conduction delay with novel telemetric signal averagingCardiac resynchronization therapy (CRT) with biventricular pacing is an established therapy for heart failure (HF) patients (P) with ventricular desynchronization and reduced left ventricular (LV) ejection fraction. The aim of this study was to evaluate electrical right atrial (RA), left atrial (LA), right ventricular (RV) and LV conduction delay with novel telemetric signal averaging electrocardiography (SAECG) in implantable cardioverter defibrillator (ICD) P to better select P for CRT and to improve hemodynamics in cardiac pacing. Methods: ICD-P (n=8, age 70.8 ± 9.0 years; 2 females, 6 males) with VVI-ICD (n=4), DDD-ICD (n=3) and CRT-ICD (n=1) (Medtronic, Inc., Minneapolis, MN, USA) were analysed with telemetric ECG recording by Medronic programmer 2090, ECG cable 2090AB, PCSU1000 oscilloscope with Pc-Lab2000 software (Velleman®) and novel National Intruments LabView SAECG software. Results: Electrical RA conduction delay (RACD) was measured between onset and offset of RA deflection in the RAECG. Interatrial conduction delay (IACD) was measured between onset of RA deflection and onset of far-field LA deflection in the RAECG. Interventricular conduction delay (IVCD) was measured between onset of RV deflection in the RVECG and onset of LV deflection in the LVECG. Telemetric SAECG recording was possible in all ICD-P with a mean of 11.7 ± 4.4 SAECG heart beats, 97.6 ± 33.7 ms QRS duration, 81.5 ± 44.6 ms RACD, 62.8 ± 28.4 ms RV conduction delay, 143.7 ± 71.4 ms right cardiac AV delay, 41.5 ms LA conduction delay, 101.6 ms LV conduction delay, 176.8 ms left cardiac AV delay, 53.6 ms IACD and 93 ms IVCD. Conclusions: Determination of RA, LA, RV and LV conduction delay, IACD, IVCD, right and left cardiac AV delay by telemetric SAECG recording using LabView SAECG technique may be useful parameters of atrial and ventricular desynchronization to improve P selection for CRT and hemodynamics in cardiac pacing.show moreshow less

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Metadaten
Author:Anja Töpfer, Ingolf Wehsener, Bruno IsmerGND, Helmut Kühnert, Jakob Allmann, Daniela Eisenträger, Hans Reiner Figulla, Matthias HeinkeGND
Publisher:Walter de Gruyter
Place of publication:Berlin, Boston
Date of Publication (online):2012/08/30
Pagenumber:4
Language:English
GND Keyword:Herzschrittmacher; Signaltechnik; Telemetrie
DDC classes:600 Technik, Medizin, angewandte Wissenschaften
Parent Title (English):Biomedical Engineering / Biomedizinische Technik
Volume:57
Issue:SI-1 Track-F
ISSN:0013-5585 (Print)
ISSN:1862-278X (Online)
First Page:6
Last Page:9
Publishing Institution:Hochschule Offenburg
Granting Institution:Hochschule Offenburg
Document Type:Conference Proceeding
Institutes:Hochschule Offenburg / Bibliografie
Acces Right:Zugriffsbeschränkt
Release Date:2014/08/28
Licence (German):License LogoEs gilt das UrhG
Note:
Proceedings BMT 2012, 46. DGBMT Jahrestagung, Jena - Track F. Biosignal Processing, 16.-19.09.2012
DOI:https://doi.org/10.1515/bmt-2012-4170