Atrial pacing and sensing characteristics in heart failure patients undergoing cardiac resynchronization therapy

Schuchert, Andreas; Aydin, Mohammed Ali; Israel, Carsten W.; Gaby, Gaby; Paul, Vince

doi:10.1016/j.eupc.2004.12.004

Cited by 6 publications

(7 citation statements)

References 18 publications

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“…[7,8] In CRT, several studies have demonstrated the long-term electrophysiological stability and associated complications of conventional lead placement. [9-12] Alternate RV lead position in CRT has demonstrated similar hemodynamic effects as RV-A in previous studies. [13-16] However, there are few data concerning long-term electrophysiological stability and associated complications in alternate RV pacing sites in CRT.…”

Section: Introductionmentioning

confidence: 66%

Right Ventricular Pacing and Sensing Function in High Posterior Septal and Apical Lead Placement in Cardiac Resynchronization Therapy

Kristiansen

Hovstad

Vollan

et al. 2012

Indian Pacing and Electrophysiology Journal

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BackgroundThe conventional right ventricular (RV) lead position in cardiac resynchronization therapy pacemakers (CRT-P) is the RV apex (RV-A). Little is known about electrophysiological stability and associated complications of pacing leads in RV high posterior septal (RV-HS) position in CRT-P.MethodsTwo hundred and thirty-five consecutive CRT-P patients were included from 1999-2010. Pacing thresholds at 0.5ms and 2.5V, sensing electrograms and lead impedances were measured at implant and repeated 1,3,6,12,18 and 24 months after CRT-P. Electrophysiological measurements of leads located in RV-A and RV-HS were analyzed retrospectively. Bipolar RV leads were used, including high impedance leads, passive fixation and active fixation.ResultsRV pacing leads were implanted in RV-A (n=79) and RV-HS (n=156). Average RV pacing thresholds from CRT implant procedure to 24-month follow-up at 0.5ms were 0.77±0.69V in RV-A and 0.71±0.35V in RV-HS (P=0.31), and at 2.5V were 0.06±0.08ms in RV-A and 0.07±0.05ms in RV-HS (P=0.12). Average RV electrogram amplitudes from baseline to 24 months after CRT were 15.3±6.9mV in RV-A and 12.1±6.0mV in RV-HS (P=0.55). Average RV impedances during follow-up were 850±286Ω in RV-A and 618±147Ω in RV-HS (P=0.57). Similar RV lead revisions between RV-A and RV-HS were observed after 2-year follow-up (P=0.55).ConclusionThe RV-HS lead position demonstrated stable and acceptable long-term pacing and sensing function, with rates of complications comparable to conventional RV-A lead position in CRT. The RV-HS lead position is feasible in CRT-P.

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Section: Introductionmentioning

confidence: 66%

Right Ventricular Pacing and Sensing Function in High Posterior Septal and Apical Lead Placement in Cardiac Resynchronization Therapy

Kristiansen

Hovstad

Vollan

et al. 2012

Indian Pacing and Electrophysiology Journal

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“…They comment that coexistent heart disease lowers impedance values. Another study by Schuchert et al (8) compared the atrial sensing and pacing parameters of CRT patients with dual chamber pacemaker patients. They found that pacing impedance did not differ between the groups at implantation but CRT patients showed significantly lower impedance values during follow-up.…”

Section: Discussionmentioning

confidence: 99%

An observational study of the effect of coronary artery disease severity on acute pacing threshold and lead impedance in patients with permanent pacemaker

Ekinci¹,

Yeşìl²,

Bayata³

et al. 2012

Anadolu Kardiyol Derg

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An observational study of the effect of coronary artery disease severity on acute pacing threshold and lead impedance in patients with permanent pacemaker Kalıcı pacemaker'lı olgularda koroner arter hastalığı ciddiyetinin akut uyarı eşiği ve lead empedansı üzerine etkisini araştıran gözlemsel bir çalışma Original Investigation Özgün Araşt›rma ABSTRACTObjective: This study investigated the effect of coronary artery disease (CAD) severity, distribution and left ventricular ejection fraction (LVEF) on acute ventricular pacing threshold and lead impedance at the time of pacemaker implantation. Methods: One hundred and thirty-two patients who received a ventricular pacemaker or internal cardioverter-defibrilator (ICD) lead in our institution between 2007-2010 were included in this observational study. Patients were divided into ICD and anti-bradycardic pacemaker (PM) groups. Groups were compared for ventricular stimulation threshold, lead impedance and LVEF. Later, groups were sub-grouped according to the severity and distribution of CAD and subgroups were compared in both groups for ventricular stimulation threshold, lead impedance. Quantitative data of groups were compared by means of independent samples t-test.Results: Ventricular pacing thresholds were found significantly higher ICD group compared with PM group (p<0.05). Impedance and LVEF values were significantly lower in ICD group (p<0.05). Impedance and ventricular pacing thresholds were comparable in subgroups of ICD and PM groups. Our study does not confirm any relationship between pacing parameters and severity-distribution of CAD and LVEF. Conclusion: Patients with ventricular ICD lead had higher pacing thresholds but lower pacing impedance values comparing with PM group. This study did not find any significant relationship between pacing parameters at implantation and LVEF, severity and distribution of CAD. (

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“…The contribution of AV synchrony to improving stroke volume in heart failure patients is well established [39,40]. In patients with severely reduced LV systolic function, any improvement in stroke volume from an appropriately timed atrial systole may be beneficial in improving hemodynamics [39,40].…”

Section: Does Av Dyssynchrony Affect Impella Hemodynamics?mentioning

confidence: 99%

Effect of Atrioventricular Dyssynchrony on Impella Hemodynamics: Mechanism and Its Clinical Implications

Baljepally

Tahir

2021

Cardiol Res

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The physiologic importance of atrial systole and atrioventricular (AV) synchrony in maintaining cardiac performance is well established. However, the role of AV synchrony in maintaining adequate Impella output has not been fully evaluated. Despite the common belief that AV dyssynchrony does not affect Impella output, given that Impella is a continuous flow device, recent reports indicate that AV dyssynchrony can lead to low Impella output in patients with cardiogenic shock complicated by complete heart block. Temporary transvenous pacing without establishing AV synchrony may fail to improve Impella hemodynamics; therefore, understanding the mechanism of low Impella output in AV dyssynchrony and promptly restoring AV synchrony may improve Impella output in such cases and lead to better outcomes.

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Atrial pacing and sensing characteristics in heart failure patients undergoing cardiac resynchronization therapy

Abstract: Compared with patients with standard pacing indications, CRT recipients have less good electrical characteristics in the atrium. Atrial pacing and sensing function should be closely monitored in CRT patients.

Cited by 6 publications

References 18 publications

Right Ventricular Pacing and Sensing Function in High Posterior Septal and Apical Lead Placement in Cardiac Resynchronization Therapy

Right Ventricular Pacing and Sensing Function in High Posterior Septal and Apical Lead Placement in Cardiac Resynchronization Therapy

An observational study of the effect of coronary artery disease severity on acute pacing threshold and lead impedance in patients with permanent pacemaker

Effect of Atrioventricular Dyssynchrony on Impella Hemodynamics: Mechanism and Its Clinical Implications

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