Abstract
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 [1]–[4]. However, no attempt has been made to acquire information on the heart’s hemodynamic activity on a beat-by-beat basis.
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References
Bennett T, Sharma A, Sutton R et al (1992) Development of a rate adaptive pacemaker based on the maximum rate-of-rise of right ventricular pressure (RV dP/dtmax). Pacing Clin Electrophysiol 15: 219–234
Rickards AF, Bombardini T, Plicchi G et al (1996) An implantable intracardiac accelerometer for monitoring myocardial contractility. Pacing Clin Electrophysiol 19:2066–2071
Osswald S, Cron T, Gradel C et al (2000) Closed-loop stimulation using intracardiac impedance as a sensor principle: correlation of right ventricular dP/dt max and intracardiac impedance during dobutamine stress test. Pacing Clin Electrophysiol 23:1502–1508
Occhetta E, Magnani A, Bortnik M et al (2003) Hemodynamic sensors: their impact in clinical practice. In: Raviele A (ed) Cardiac Arrhythmias 2003. Springer, Milan, pp 713–718
Di Gregorio F, Morra A, Finesso M, Bongiorni MG (1996) Transvalvular impedance (TVI) recording under electrical and pharmacological cardiac stimulation. Pacing Clin Electrophysiol 19:1689–1693
Gasparini M, Curnis A, Mantica M et al (2001) Hemodynamic sensors: what clinical value do they have in heart failure? In: Raviele A (ed) Cardiac Arrhythmias 2001. Springer, Milan, pp 576–585
Chirife R, Ortega DF, Salazar A (1993) Feasibility of measuring relative right ventricular volumes and ejection fraction with implantable rhythm control devices. Pacing Clin Electrophysiol 16:1673–1683
Chirife R, Tentori MC, Mazzetti H, Dasso D (2001) Hemodynamic sensors: are they all the same? In: Raviele A (ed) Cardiac Arrhythmias 2001. Springer, Milan, pp 566–575
Di Gregorio F, Curnis A, Pettini A et al (2002) Trans-valvular impedance (TVI) in the hemodynamic regulation of cardiac pacing. In: Mitro P, Pella D, Rybár R, Valočvik G (eds) Cardiovascular Diseases 2002. Monduzzi Editore, Bologna, pp 53–57
Bongiorni MG, Soldati E, Arena G et al (2005) Haemodynamic assessment by transvalvular impedance recording. In: Gulizia MM (ed) Emerging pathologies in cardiology. Springer, Milan, pp 323–330
Gasparini G, Curnis A, Gulizia M et al (2005) Rate-responsive pacing regulated by cardiac haemodynamics. Europace 7:234–241
Bongiorni MG, Soldati E, Arena G et al (2003) Transvalvular impedance: does it allow automatic capture detection? In: Raviele A (ed) Cardiac Arrhythmias 2003. Springer, Milan, pp 733–739
Duru F, Bauersfeld U, Schüller H et al (2000) Threshold tracking pacing based on beat by beat evoked response detection: clinical benefits and potential problems. J Intervent Cardiol Electrophysiol 4:511–522
Candinas R, Liu B, Leal J et al (2002) Impact of fusion avoidance on performance of the automatic threshold tracking feature in dual chamber pacemakers: a multicenter prospective randomized study. Pacing Clin Electrophysiol 25:1540–1545
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© 2007 Springer-Verlag Italia
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Occhetta, E., Bortnik, M., Di Gregorio, F., Barbetta, A., Marino, P. (2007). Applications of TVI Sensing in Cardiac Stimulation. In: Gulizia, M.M. (eds) Current News in Cardiology. Springer, Milano. https://doi.org/10.1007/978-88-470-0636-2_39
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DOI: https://doi.org/10.1007/978-88-470-0636-2_39
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0635-5
Online ISBN: 978-88-470-0636-2
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