Endocardial vagal atrioventricular node stimulation in humans: reproducibility on 18-month follow-up
| Autor: | Sergio Valsecchi, Daniele Porcelli, Pietro Rossi, Antonio Lucifiero, F. Sgreccia, Mario Malavasi, Raffaele Quaglione, Paolo Azzolini, Massimiliano Campoli, Gianfranco Piccirillo, Stefano Bianchi, Sergio Canonaco |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Stimulation Heart Conduction System Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Longitudinal Studies Lead (electronics) Aged Reproducibility business.industry Pulse (signal processing) Cardiac Pacing Artificial Reproducibility of Results Atrial fibrillation Middle Aged medicine.disease Atrioventricular node Atrial Lead Defibrillators Implantable medicine.anatomical_structure Treatment Outcome Anesthesia Dromotropic Cardiology Atrioventricular Node Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 12(12) |
| ISSN: | 1532-2092 |
| Popis: | Aims Control of atrioventricular (AV) node conduction by means of high-frequency stimulation (HFS) of efferent AV node vagal stimulation (AVNS) fibres enables the ventricular rate (VR) to be modulated during atrial fibrillation (AF). The aims of this study were to verify, on 18-month follow-up, the reproducibility of the dromotropic effect obtained on implantation and the long-term reliability of the system in patients who received an implantable cardioverter-defibrillator (ICD) with a standard atrial lead positioned at a location suitable for AVNS. Methods and results We enrolled 12 patients with paroxysmal or persistent AF who were candidates for ICD. The right atrium was mapped to locate the pacing site, and a transvenous screw-in lead was implanted in that region. The voltages required for VR modulation (25% VR reduction) and complete AV block at different pulse durations (from 0.1 to 0.5 ms) were recorded. Eleven out of 12 patients underwent 18-month follow-up examination. Atrial pacing parameters were adequate and did not differ from the baseline values (all P > 0.05): pacing threshold 0.9 ± 0.5 V (0.5 ms pulse duration) and impedance 556 ± 121 Ω, with P-wave amplitude of 1.6 ± 0.7 mV. High-frequency stimulation induced VR modulation in nine patients and complete AV block in eight patients at pulse durations ≥0.3 ms. No differences were observed in the voltages for VR modulation and complete AV block between implantation and 18-month examination (all P > 0.100). Conclusion Ventricular rate control during AF was obtained under HFS 18 months after implantation in patients with the atrial lead positioned at a location suitable for AVNS. The pacing outputs needed to achieve the dromotropic effect were comparable to those measured on implantation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|