Document Detail


Temporary leadless pacing in heart failure patients with ultrasound-mediated stimulation energy and effects on the acoustic window.
MedLine Citation:
PMID:  19427274     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left ventricular stimulation for cardiac resynchronization therapy is largely limited by access and anatomy of coronary veins. OBJECTIVE: This study sought to apply ultrasound-mediated leadless pacing technology in heart failure patients and to evaluate the effects of respiration and body posture on the acoustic window. METHODS: Patients with advanced heart failure and ejection fraction <or=35% were studied. An electrophysiology catheter incorporating a receiver electrode to deliver ultrasound-mediated pacing was positioned in the left ventricle. Ultrasound-mediated pacing thresholds were determined. The acoustic windows on the chest wall with the patient lying supine, titled 30 degrees leftward, 30 degrees rightward, and 30 degrees upward were determined. The acoustic windows were also determined with computed tomography and transthoracic echocardiography. Simulated receiver movement with respiratory movement and body positioning was assessed with computed tomography. RESULTS: Ten patients were studied. Ultrasound-mediated pacing was successful in all patients. The acoustic window measured 39.6 +/- 18.2 cm(2). The window size decreased with rightward tilt, and increased with leftward and upward tilt. They correlated with measurements made by transthoracic echocardiography and computed tomography. Target receiver movement of 1.2 +/- 1.4 cm horizontally and 1.3 +/- 0.8 cm vertically were estimated by computed tomography. CONCLUSION: The feasibility of leadless left ventricular stimulation was shown acutely in heart failure patients. The acoustic window validated by computed tomography was predicted by transthoracic echocardiography. Effects of respiration and body posture were evaluated for development of the future implantable device.
Authors:
Kathy L Lee; Hung-Fat Tse; Debra S Echt; Chu-Pak Lau
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-02-24
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  6     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-26     Completed Date:  2009-10-08     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  742-8     Citation Subset:  IM    
Affiliation:
Cardiology Division, Department of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China. klflee@hku.hk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiac Pacing, Artificial / methods*
Electrodes, Implanted
Equipment Design
Female
Heart Failure / therapy*
Humans
Male
Middle Aged
Pacemaker, Artificial*
Severity of Illness Index
Stroke Volume
Time Factors
Treatment Outcome
Ultrasonography, Interventional / instrumentation*
Comments/Corrections
Comment In:
Heart Rhythm. 2009 Jun;6(6):749-51   [PMID:  19467502 ]

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


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