Pacing with capture verification in candidates for resynchronisation therapy: A feasibility study

被引：8

作者：

Biffi, M ^{[1
]}

Boriani, G ^{[1
]}

Bertini, M ^{[1
]}

Silvestri, P ^{[1
]}

Martignani, C ^{[1
]}

Branzi, A ^{[1
]}

机构：

[1] Univ Bologna, Inst Cardiol, I-40138 Bologna, Italy

来源：

EUROPACE | 2005年 / 7卷 / 03期

关键词：

heart failure; resynchronisation therapy; autocapture; evoked response;

D O I：

10.1016/j.eupc.2005.01.007

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Devices for cardiac resynchronisation therapy (CRT) deliver energy into 3 output channels. Such a burden can significantly reduce device longevity. Autocapture (TM) has been shown to improve pacemaker longevity and safety of right ventricular pacing in clinical studies. The aim of this study was to investigate the application of Autocapture (TM) during biventricular pacing (BIV) to decrease the energy cost of CRT. Methods During implantation of BIV devices, an acute study was performed to test the hypothesis that the evoked response (ER) elicited by each delivered stimulus is correctly detected and measured either on the right ventricular (RV) channel during BIV pacing with the left ventricular (LV) channel pacing first, or in the LV channel with the RV channel pacing first. A reliable measurement of ER is the critical requirement for the correct performance of Autocapture (TM). Results ER amplitude in the right ventricle during BIV pacing was not significantly decreased compared with RV pacing in the VVI mode (16.36 +/- 5.27 mV vs 17.09 +/- 6.12 mV). ER amplitude in the left ventricle during BIV pacing was not significantly decreased compared with LV pacing in the VVI mode (12.4 +/- 8.95 mV vs 12.25 +/- 8.97 mV). Three patients in atrial fibrillation had a DDDR pacemaker with the LV lead connected to the atrial port, and received BIV pacing with Autocapture (TM) turned on in the RV channel. Autocapture (TM) performance in the long term, as assessed by the trend of RV threshold over 20 8 months, showed that LV depolarisation was never sensed as an ER on the RV channel. Conclusions Our observations support the feasibility and safety of capture verification during BIV pacing on the ventricular channel paced secondly, which could increase the longevity of CRT devices, therapy for heart failure patients. (c) 2005 The European Society of Cardiology. reserved. and decrease the costs of this new Published by Elsevier Ltd. All rights reserved.

引用

页码：255 / 265

页数：11

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