Atrioventricular Sequential Pacemakers: Indications, Complications, and Long-Term Follow-up

Kitzes, David L.; Mohammad, Arif; Carleton, Richard A.; Goldberg, M E; Burnard, Ralph J.; Weyman, Albert K.; Yashar, James J.

doi:10.1016/s0003-4975(10)61638-4

Cited by 16 publications

(2 citation statements)

References 24 publications

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“…When the heart is paced in an AV synchronized manner, it is estimated to increase stroke volume by 50% in normal hearts and increase the cardiac index by 25%–30% compared to ventricular‐only pacing. AV synchronization performs better at maintaining proper cardiac output than ventricular pacing alone and is essential in achieving optimal cardiovascular hemodynamics 3–5 …”

Section: Introductionmentioning

confidence: 99%

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A novel temporary atrioventricular sequential pacing catheter—Characteristics and first‐in‐human application

Pérez¹,

Ebner

Kall

et al. 2022

Journal of Cardiac Surgery

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Background: Sequential synchronized atrioventricular (AV) pacing provides enhanced electrophysiologic parameters which contribute to improved hemodynamic parameters and increased cardiac performance to subsequently confer a clinical advantage over traditional ventricular pacing. Current temporary transvenous pacemaker catheters are limited to only one electrode which paces solely the right ventricle, thus lacking the capability to provide the optimal pacing mode. A new multilead pacemaker device was developed in response to the need for improved temporary pacing through the utilization of sequential synchronized atrioventricular pacing (TAVSP). It consists of seven preformed, preshaped nitinol wires electrodes, of which four are for intra-atrial and three for intraventricular positioning and endocardial contact, respectively. Each wire carries a ball tip designed to minimize tissue trauma and provide a high current density for adequate myocardial capture. The device is not yet Food and Drug Administration approved.Objective: To present the unique structural components and mechanical properties of a novel sequential synchronized AV pacing device for temporary insertion and to report its first-in-human application with an analysis of the early clinical experience.Methods: Following a process of development and proof of concept of the novel pacing modality in an animal model which demonstrated feasibility and safety, a series of patients who were candidates for the device application was identified. During left and right heart catheterization, the novel temporary pacing catheter was inserted transvenously and delivered in most patients under fluoroscopy or echocardiography.The catheter was deployed to its target right heart anatomic sites and then activated in an AV sequential mode. The technical aspects, the corresponding clinical utilization, and device performance were documented and analyzed. Results:The series included 10 enrolled subjects. During planned left and right heart catheterization, the novel TAVSP device was inserted transvenously and then delivered and deployed successfully in a timely fashion in all patients. The pacing catheter achieved proper threshold and impedance in all (100%) patients. The performance of all ventricular leads was adequate; however, in 1 (10%) patient poor performance of the atrial leads was detected. The device was successfully retrieved in all patients. No adverse arrhythmia, impaired hemodynamics, or clinical adverse

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Section: Introductionmentioning

confidence: 99%

“…AV synchronization performs better at maintaining proper cardiac output than ventricular pacing alone and is essential in achieving optimal cardiovascular hemodynamics. [3][4][5] Accordingly, there is a clinical need for a user-friendly technically sophisticated temporary transvenous AV sequential pacing catheter.…”

Section: Introductionmentioning

confidence: 99%