Validation of a Marker of Atrial Contraction in the SonR Signal

Abstract

Introduction: The main component of the endocardial acceleration signal (SonR) is today used for cardiac resynchronization therapy (CRT) optimization. This prospective, single center pilot study focuses on another signal component, SonR4 that may provide further information on the atrial activity. Methods and Results: SonR signal and ECG tracings were recorded simultaneously during a CRT-D optimization procedure in 15 patients (12 men, 68 ± 9.5 years, ischemic heart disease 53%) indicated for CRT. Correlation between SonR4 signal, recorded using SonR and atrial contraction, identified by Echo Doppler was evaluated by Pearson and Student's t tests under different Atrio-Ventricular (AV) delay programming. From 15 consecutive screened patients, 9 had concomitant analyzable SonR4 and ECG recordings and were included in the study population. The presence of the SonR4 component was systematically correlated to the presence of the A wave. A significant correlation was observed between SonR4 and A wave timings (r = 0.75, p = 0.02) according to different AV delays, with a high reproducibility in SonR4 assessment. Conclusion: A strong correlation between SonR4 and atrial contraction timings was observed, further suggesting that SonR4 is a marker of the atrial contraction. Additional assessments in larger populations are required to confirm these results and build further applications.