Hemodynamic Surveillance of Ventricular Pacing Effectiveness with the Transvalvular Impedance Sensor. (4th August 2014)

• Record Type: Journal Article
• Authors: Calvi, Valeria; Pizzimenti, Giovanni; Lisi, Marco; Doria, Giuseppe; Vasquez, Ludovico; Lisi, Francesco; Felis, Salvatore; Tempio, Donatella; Virgilio, Alfredo; Barbetta, Alberto; Di Gregorio, Franco
• Other Names: Kusmic Claudia Academic Editor.
• Is Part Of: Advances in medicine. Volume 2014(2014)
• Publication Date: 2014-08-04
• Subjects: Medicine -- Periodicals; Clinical medicine -- Periodicals; Clinical Medicine; Clinical medicine; Medicine; Periodicals; Electronic journals; Periodicals; 610
• DOI: 10.1155/2014/307168
• Languages: English
• ISSNs: 2356-6752

Abstract

Abstract : The Transvalvular Impedance (TVI) is derived between atrial and ventricular pacing electrodes. A sharp TVI increase in systole is an ejection marker, allowing the hemodynamic surveillance of ventricular stimulation effectiveness in pacemaker patients. At routine follow-up checks, the ventricular threshold test was managed by the stimulator with the supervision of a physician, who monitored the surface ECG. When the energy scan resulted in capture loss, the TVI system must detect the failure and increase the output voltage. A TVI signal suitable to this purpose was present in 85% of the tested patients. A total of 230 capture failures, induced in 115 patients in both supine and sitting upright positions, were all promptly recognized by real-time TVI analysis (100% sensitivity). The procedure was never interrupted by the physician, as the automatic energy regulation ensured full patient's safety. The pulse energy was then set at 4 times the threshold to test the alarm specificity during daily activity (sitting, standing up, and walking). The median prevalence of false alarms was 0.336%. The study shows that TVI-based ejection assessment is a valuable approach to the verification of pacing reliability and the autoregulation of ventricular stimulation energy.