Document Detail


Effect of ischemia on implantable defibrillator intracardiac shock electrograms.
MedLine Citation:
PMID:  18081761     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Few attempts have been made to extract information from the ventricular electrogram (EGM) recorded by implantable cardioverter defibrillators (ICD) aside from the discrimination of supraventricular tachycardia and ventricular tachycardia. The current study aims to examine the effect of ischemia in the major coronary artery distributions on the shock EGM from ICDs. METHODS: Domestic crossbred pigs (n = 10, 20-40 kg) were implanted with a dual-coil right ventricular defibrillation system. Through the femoral approach, percutaneous balloon occlusion of the major coronary arteries was performed. The left anterior descending (LAD), left circumflex (LCx), and right coronary (RCA) arteries were occluded in random order for 3-5 minutes with 30-minute periods of reperfusion in between and the shock EGMs were recorded and analyzed. RESULTS: During peak ischemia, R wave amplitude increased by a mean of 204.3% (P = 0.003), increased by a mean of 73.8% (P = 0.0009), and decreased by a mean of 28.0% (P = 0.109) in the LAD, LCx, and RCA territories, respectively. During peak ischemia ST segments elevated by a mean of 105.3% (P = 0.041), elevated by a mean of 114.9% (P = 0.064), and decreased by a mean of 584.5% (P = 0.006) in the LAD, LCx, and RCA territories, respectively. CONCLUSIONS: Ischemia affects ICD shock EGMs in a manner that appears to vary depending on the culprit vessel. Our data demonstrate the feasibility of ischemia detection from ICD shock EGMs.
Authors:
Jeffrey L Williams; G Stuart Mendenhall; Samir Saba
Publication Detail:
Type:  Journal Article     Date:  2007-12-12
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  19     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-27     Completed Date:  2008-03-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  275-81     Citation Subset:  IM    
Affiliation:
Cardiovascular Institute of the University of Pittsburgh, Pittsburgh, Pennsylvania, USA. williamsjl4@upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Defibrillators*
Electrocardiography / instrumentation,  methods*
Feasibility Studies
Myocardial Ischemia / diagnosis*,  prevention & control*
Swine
Tachycardia, Ventricular / diagnosis*,  prevention & control*
Treatment Outcome
Comments/Corrections
Comment In:
J Cardiovasc Electrophysiol. 2008 Mar;19(3):282-4   [PMID:  18179524 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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