Left and Right Parasternal Sensing for the S-ICD in Adult Congenital Heart Disease Patients and Normal Controls

Autor:	David G. Wilson, Mehmood Zeb, John M. Morgan, Borislav D. Dimitrov, Gruschen R. Veldtman
Rok vydání:	2016
Předmět:	Left and right medicine.medical_specialty Supine position Heart disease business.industry medicine.medical_treatment General Medicine 030204 cardiovascular system & hematology Implantable cardioverter-defibrillator Sitting medicine.disease Confidence interval 03 medical and health sciences 0302 clinical medicine Parasternal line Internal medicine Cardiology Medicine In patient 030212 general & internal medicine Cardiology and Cardiovascular Medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 39:282-290
ISSN:	0147-8389
DOI:	10.1111/pace.12802
Popis:	Background - This study investigated the impact of a right parasternal sensing electrode position on the R- and T-wave amplitudes and the R:T ratio in three subcutaneous implantable cardioverter defibrillator (S-ICD) vectors in patients with adult congenital heart disease (ACHD) and normal controls. Methods - Conventional left parasternal sensing electrode position and right parasternal sensing electrode positions were used to collect 10-second electrograms, recorded through an 80-electrode body surface mapping technology (Prime ECG™ system, Heartscape Technologies Inc., now Verathon, Columbia, MD, USA). Recordings were made in the supine, prone, left lateral, right lateral, sitting, and standing positions in using both the standard electrode vector position and the right parasternal positions. Results - Forty patients were recruited and 37 patients were used for analysis. Twenty-seven (73%) had complex ACHD; 10 patients had normal hearts and acted as controls. A total of 3,708 data points were analyzed. There were no significant differences in the R:T ratio when measured in ACHD patients in the right compared to the left parasternal lead position. In contrast, there were important differences in the magnitude of the R:T ratio when measured in control patients in the right compared to the left parasternal lead position; in the primary vector, the R:T ratio was greater in right than left by 2.99 (P = 0.0002; 95% confidence interval [CI]: 1.48–4.50) and in the secondary vector, the R:T ratio was smaller in the right than in the left by 0.77 (P = 0.004; 95% CI: ?1.58–0.05). Conclusion - In selected patients, a right parasternal lead position may provide a useful alternative sensing configuration for the S-ICD.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::685ed4e9aa808861e1c6986dabdcd866 https://doi.org/10.1111/pace.12802 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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