Document Detail

Attenuation of post-shock increases in brain natriuretic Peptide with post shock overdrive pacing.
MedLine Citation:
PMID:  20234809     Owner:  NLM     Status:  PubMed-not-MEDLINE    
BACKGROUND: Predischarge defibrillation threshold testing is often performed a few days after ICD implantation in order to validate defibrillation thresholds obtained at the time of implant. Ventricular fibrillation is induced with such testing and causes an increase in serum Brain Natriuretic Peptide (BNP) levels. BNP is an indicator for cardiac stress. We wanted to examine the feasibility to alter the trend of BNP after predischarge testing in VVI, DDD and CRT ICD's.
METHODS: We measured BNP before predischarge testing and 5, 10, 20 and 40 minutes after predischarge testing in 13 groups with each 20 patients. We evaluated patients without post shock pacing and patients with a post shock pacing frequency of 60, 70, 80, 90 and 100 bpm and a duration of 30 and 60 sec as well as a post shock pacing frequency of 80 and 90 bpm and a duration of 120 sec post shock pacing.
RESULTS: Patients without post shock pacing showed the highest BNP during the follow-up. The percentage values of BNP increased consistent significantly after 5 minutes compared with BNP before predischarge testing. The percentage values of BNP trend was significantly lower with a post shock pacing of 90 bpm and duration of 60 sec. In addition, we excluded a cardiac necrosis by predischarge testing because of similar values of myoglobin, cardiac troponin I and creatine kinase during the follow-up.
CONCLUSIONS: Our results suggested that post shock pacing with 90 bpm and duration of 60 sec as the best optimized post shock pacing frequency and duration for VVI, DDD and CRT ICD's. A reduction of cardiac stress is going to be achieved with the optimization of the post shock pacing frequency and duration.
Marco Budeus; Emanuel Salibassoglu; Anna Maria Schymura; Nico Reinsch; Nils Lehmann; Heinrich Wieneke; Stefan Sack; Raimund Erbel
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Publication Detail:
Type:  Journal Article     Date:  2010-03-05
Journal Detail:
Title:  Indian pacing and electrophysiology journal     Volume:  10     ISSN:  0972-6292     ISO Abbreviation:  Indian Pacing Electrophysiol J     Publication Date:  2010  
Date Detail:
Created Date:  2010-03-17     Completed Date:  2010-05-20     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101157207     Medline TA:  Indian Pacing Electrophysiol J     Country:  India    
Other Details:
Languages:  eng     Pagination:  122-38     Citation Subset:  -    
Department of Cardiology, West-German Heart Centre, University of Duisburg-Essen, Germany.
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