Applications of TVI Sensing in Cardiac Stimulation
Permanent cardiac stimulation has become increasingly complex, and modern pacing devices are now equipped with a wide set of functions aimed at reproducing as closely as possible the physiological control of cardiac rhythm, including dual-chamber and three-chamber architecture, sensordriven rate-response, careful management, and rate-adaptation of the atrioventricular delay. Special algorithms have been developed to allow pacing and sensing autoregulation, self-limitation of unnecessary ventricular stimulation, pacing-mode switch in the event of supraventricular tachyarrhythmias, overdrive pacing aimed at preventing atrial fibrillation, etc. However, in spite of the improved effectiveness in sensing and processing cardiac electric signals, standard pacemakers do not take into account the associated mechanical activity, which is the final expression of ventricular function. So far, a few special models have been equipped with hemodynamic sensors, which are used to assess changes in myocardial contractility and accordingly regulate rate-responsive pacing –. However, no attempt has been made to acquire information on the heart’s hemodynamic activity on a beat-by-beat basis.
KeywordsVentricular Pace Systolic Ejection Cardiac Stimulation Overdrive Pace Threshold Tracking
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