Refine
Year of publication
Document Type
- Conference Proceeding (58)
- Article (reviewed) (11)
- Contribution to a Periodical (2)
- Patent (2)
- Article (unreviewed) (2)
Conference Type
- Konferenz-Abstract (43)
- Konferenzartikel (12)
- Konferenz-Poster (3)
Has Fulltext
- no (75) (remove)
Is part of the Bibliography
- yes (75) (remove)
Keywords
- CST (7)
- HF-Ablation (7)
- CRT (5)
- Herzkrankheit (5)
- Synchronisierung (4)
- Herzschrittmacher (3)
- Cardiac resynchronization therapy (2)
- Elektrokardiogramm (2)
- IVD (2)
- Kardiale Resynchronisationstherapie (2)
Institute
- Fakultät Elektrotechnik und Informationstechnik (E+I) (bis 03/2019) (75) (remove)
Open Access
- Open Access (45)
- Closed Access (26)
- Closed (1)
Die Erfindung betrifft eine Ösophaguselektrodensonde bzw. einen Ösophaguskatheter 10 zur Bioimpedanzmessung und/oder zur Neurostimulation, eine Vorrichtung 100 zur transösophagealen kardiologischen Behandlung und/oder kardiologischen Diagnose und ein Verfahren zum Steuern oder Regeln einer Ablationseinrichtung zum Durchführen einer Herzablation. Die Ösophaguselektrodensonde 10 umfasst eine Bioimpedanzmesseinrichtung zur Messung der Bioimpedanz von zumindest einem Teil des die Ösophaguselektrodensonde 10 umgebenden Gewebes. Die Bioimpedanzmesseinrichtung umfasst mindestens eine erste Elektrode 12A und mindestens eine zweite Elektrode 12B, wobei die mindestens eine erste Elektrode 12A auf einer dem Herzen zugewandten Seite 14 der Ösophaguselektrodensonde 10 angeordnet ist, und die mindestens eine zweite Elektrode 12B auf einer vom Herzen abgewandten Seite 16 der Ösophaguselektrodensonde 10 angeordnet ist.Die Vorrichtung 100 umfasst die Ösophaguselektrodensonde 10 und eine Steuer- und/oder Auswerteinrichtung 30. Die Steuer- und/oder Auswerteinrichtung 30 ist eingerichtet, ein erstes Bioimpedanzmesssignal von der mindestens einen ersten Elektrode 12A und ein zweites Bioimpedanzmesssignal von der mindestens einen zweiten Elektrode 12B zu empfangen und zu vergleichen, und ein Kontrollsignal auf Basis des Vergleichs zu generieren. Das Kontrollsignal kann ein Signal zum Steuern oder Regeln einer Ablationseinrichtung zum Durchführen einer Herzablation sein.
Vergleich der hämodynamischen Reaktion auf VV-Delay Änderungen bei Sinusrhythmus und Vorhofflimmern
(2010)
Das Ausmaß der elektrischen ventrikulären Desynchronisation bei reduzierter linksventrikulärer Funktion ist von Bedeutung für den Erfolg der Resynchronisationstherapie der Herzinsuffizienz mit biventrikulärer Stimulation. Das Ziel der Untersuchung besteht in der nichtinvasiven Messung der elektrischen inter-ventrikulären Desynchronisation mit und ohne ischämische Herzerkrankung bei kardialen Resynchronisationstherapie Respondern. Bei Patienten mit 25,3 ± 7,3 % reduzierter linksventrikulärer Ejektionsfraktion und 166,9 ± 38,5 ms QRS-Dauer wurde das transösophageale linksventrikuläre EKG abgeleitet. Die QRS-Dauer korrelierte mit dem interventrikulären und links-ventrikulären Delay bei Resynchronisationstherapie Respondern mit nicht-ischämischer Herzerkrankung.
Cardiac resynchronization therapy is an established therapy for heart failure patients with sinus rhythm, reduced left ventricular ejection fraction and prolongation of QRS duration. The aim of the study was to evaluate ventricular desynchronization with electrical interventricular delay (IVD) to left ventricular delay (LVD) ratio in atrial fibrillation heart failure patients. IVD and LVD were measured by transesophageal posterior left ventricular ECG recording. In atrial fibrillation heart failure patients with prolonged QRS duration, the mean IVD-to-LVD-ratio was 0.84 +/- 0.42 with a range from 0.17 to 2.2 IVD-to-LVD-ratio. IVD-to-LVD-ratio correlated with QRS duration. IVD-to-LVD-ratio may be a useful parameter to evaluate electrical ventricular desynchronization in atrial fibrillation heart failure patients.
Introduction: Cardiac resynchronization therapy (CRT) with biventricular pacing (BV) is an established therapy for heart failure (HF) patients (P) with ventricular desynchronisation, but not all patients improved clinically. Aim of this study was to evaluate electrical intra-left ventricular conduction delay (LVCD) and interventricular conduction delay (IVCD), to better select patients for CRT.
Methods: 65 HF patients (age 63.4 ± 10.6 years; 7 females, 58 males) with New York Heart Association (NYHA) class 3 ± 0.2, 24.4 ± 6.7 % left ventricular (LV) ejection fraction and 167.4 ± 35.6 ms QRSD were included. Esophageal TO Osypka focused hemispherical electrodes catheter was perorally applied in position of maximum LV deflection to measure LVCD between onset and offset of LV deflection and IVCD between earliest onset of QRS in the 12-channel surface ECG and onset of LV deflection in the focused bipolar transesophageal LV electrogram.
Results: There were 50 responders with LVCD of 76.5 ± 20.4 ms, IVCD of 80.5 ± 26.1 ms (P=0.34) and QRSD of 171 ± 37.7 ms. 15 non-responders had longer LVCD of 90 ± 28.5 ms (P = 0.045), shorter IVCD of 50.1 ± 29.1 ms (P < 0.001) and QRSD of 155.3 ± 25 ms (P=0.14). During 21.3 ± 20.3 month BV pacing follow-up, the responder`s NYHA classes improved from 3 ± 0.2 to 2. ± 0.3 (P < 0.001) whereas the non-responders NYHA classes did not improve from 3 ± 0.2 to 2.9 ± 0.3 (P = 0.43) during 15.7 ± 13.9 month BV pacing follow-up (53 Boston, 10 Medtronic and 2 St. Jude CRT devices).
Conclusion: Determination of electrical LVCD and IVCD by focused bipolar transesophageal LV electrogram recording may be an additional useful technique to improve patient selection for CRT.
Transösophageales interventrikuläres Delay bei Vorhofflimmern und kardialer Resynchronisation
(2013)
Die transösophageale linksventrikuläre Elektrokardiographie ermöglicht die Evaluierung der elektrischen ventrikulären Desynchronisation im Rahmen der kardialen Resynchronisationstherapie der Herzinsuffizienz. Das Ziel der Untersuchung besteht in der präoperativen Abschätzung des transösophagealen interventrikulären Delays bei Vorhofflimmern und kardialer Resynchronisationstherapie. Bei Patienten mit Vorhofflimmern, Herzinsuffizienz New York Heart Association Klasse 3,0 ± 0,2 und QRS-Dauer 159,6 ± 23,9 ms wurde das fokusierte transösophageale linksventrikuläre EKG abgeleitet. Die kardiale Resynchronisationstherapie Responder QRS-Dauer korrelierte mit dem transösophagealen interventrikulären Delay bei Vorhofflimmern.
Transthoracic impedance cardiography (ICG) is a non-invasive method for determination of hemodynamic parameters. The basic principle of transthoracic ICG is the measurement of electrical conductivity of the thorax over the time. The aim of the study was the analysis of hemodynamic parameters from healthy individuals and the evaluation of various hemodynamic monitoring devices. Fourteen men (mean age 25 ± 4.59 years) and twelve women (mean age 24 ± 3.5 years) were measured during the cardiovascular engineering laboratory at Offenburg University of Applied Sciences, Offenburg, Germany. The ICG recordings were measured with the devices CardioScreen 1000, CardioScreen 2000 and TensoScreen with the corresponding Software Cardiovascular Lab 2.5 (Medis Medizinische Messtechnik GmbH, Illmenau, Germany). In order to create identical frame conditions, all measurements were recorded in the same position and for the same duration. Various positions were simulated from horizontal lying position to vertical standing position. Altogether, more than 30 hemodynamic parameters were measured.
Cardiac resynchronization therapy (CRT) with biventricular pacing (BV) is an established therapy for heart failure (HF) patients with inter- and intraventricular conduction delay. The aim of this pilot study was to test the feasibility of both transesophageal measurement of left ventricular (LV) electrical delay and transesophageal LV pacing prior to implantation, to better select patients for CRT.
Introduction: Cardiac resynchronization therapy (CRT) with biventricular pacing is an established therapy for heart failure (HF) patients with sinus rhythm and ventricular desynchronisation. The aim of this study was to evaluate interventricular conduction delay (IVCD) and interatrial conduction delay (IACD) before and after premature ventricular contractions (PVC) in HF patients.
Methods: 13 HF patients (age 68 ± 10 years; 2 females, 11 males) with New York Heart Association functional class 2,8 ± 0.5, left ventricular (LV) ejection fraction 28,6 ± 12,6 %, 154 ± 25 ms QRS duration and PVC were analysed with bipolar transesophageal LV and left atrial electrogram recording and National Instruments LabView 2009 software. The level of significance of the t-test is 0,005.
Results: QRS duration increases during PVC (188 ± 32 ms) in comparison to the beat before (154 ± 25 ms, P = ) and after PVC (152 ± 25 ms,). IVCD increases during PVC up to 65 ± 33 ms (51 ± 19 ms in the beat before PVC, P=0.18, 49 ± 19 ms after PVC, P = 0.12). Intra-LV delay of 90 ± 16 ms is not different in the beat before PVC, 90 ± 14 ms during PVC (P = 0.99) and 94 ± 16 ms in the beat after PVC (P = 0.38). IACD is not significantly PVC influenced (67 ± 12 ms before PVC and 65 ± 13 ms after PVC, P = 0.71). Intra-left atrial conduction delay is not significant longer during PVC (57 ± 28 ms) than in the beat before PVC (54 ± 13 ms, P = 0.51) or after PVC (54 ± 8 ms, P = 0.45). PQ duration increases significantly after PVC (224 ± 95 ms) in comparison to the beat before PVC (176± 29 ms, P =...).
Conclusion: Transesophageal left cardiac electrocardiography with LabView 2009 software can improve evaluation of IVCD and IACD before, during and after PVC in HF patient selection for CRT.
Targeting complex fractionated atrial electrocardiograms by automated algorithms during ablation of persistent atrial fibrillation has produced conflicting outcomes in previous electrophysiological studies and catheter ablation of atrial fibrillation and ventricular tachycardia. The aim of the investigation was to evaluate atrial and ventricular high frequency fractionated electrical signals with signal averaging technique.
Methods: Signal averaging electrocardigraphy allows high resolution ECG technique to eliminate interference noise signals in the recorded ECG. The algorithm use automatic ECG trigger function for signal averaged transthoracic, transesophageal and intra-cardiac ECG signals with novel LabVIEW software.
Results: The analysis in the time domain evaluated fractionated atrial signals at the end of the signal averaged P-wave and fractionated ventricular signals at the end of the QRS complex. We evaluated atrial flutter in the time domain with two-to-one atrioventricular conduction, 212.0 ± 4.1 ms atrial cycle length, 426.0 ± 8.2 ms ventricular cycle length, 58.2 ± 1.8 ms P-wave duration, 119.6 ± 6.4 ms PQ duration, 103.0 ± 2.4 ms QRS duration and 296.4 ± 6.8 ms QT duration. The analysis in the frequency domain evaluated high frequency fractionated atrial signals during the P-wave and high frequency fractionated ventricular signals during QRS complex.
Conclusions: Spectral analysis of signal averaging electrocardiography with novel LabVIEW software can be utilized to evaluate atrial and ventricular conduction delays in patients with atrial fibrillation and ventricular tachycardia. Complex fractionated atrial and ventricular electrocardiograms may be useful parameters to evaluate electrical cardiac bradycardia and tachycardia signals in atrial fibrillation and ventricular tachycardia ablation.