2010
DOI: 10.1093/europace/euq052
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Left ventricular mechanical activity detected by impedance recording

Abstract: AimsRecording and analysing impedance fluctuation along the cardiac cycle in the right (RV) and left ventricles (LV).Methods and resultsDuring a biventricular (BiV) implantation procedure, impedance was sequentially derived between the atrial ring electrode and either electrode (tip or ring) of the RV lead [transvalvular impedance (TVI)], and between the atrial ring and either the tip or ring electrode of a coronary sinus lead, positioned in a cardiac vein [left ventricle impedance (LVI)]. The LVI signal was a… Show more

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Cited by 8 publications
(6 citation statements)
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“…With this pacing mode, the TVI waveform recorded with the tip ventricular electrode often showed an early and steep rise, which made difficult the measurement of the minimum presystolic value. Since TVI is modulated by cross-section changes occurring in the ventricular region where the recording electrode is placed [ 17 , 18 ], which was the right apex in the present experience, we could speculate that the movement of the stimulated ventricular myocardium is delayed by the active blood inflow, especially if the AV delay is short, or by passive stretching of the ventricular wall which might be caused by the atrial contraction. For all these reasons, the use of TVI for capture verification during VVI pacing was possible in 85% of the cases.…”
Section: Discussionmentioning
confidence: 88%
See 1 more Smart Citation
“…With this pacing mode, the TVI waveform recorded with the tip ventricular electrode often showed an early and steep rise, which made difficult the measurement of the minimum presystolic value. Since TVI is modulated by cross-section changes occurring in the ventricular region where the recording electrode is placed [ 17 , 18 ], which was the right apex in the present experience, we could speculate that the movement of the stimulated ventricular myocardium is delayed by the active blood inflow, especially if the AV delay is short, or by passive stretching of the ventricular wall which might be caused by the atrial contraction. For all these reasons, the use of TVI for capture verification during VVI pacing was possible in 85% of the cases.…”
Section: Discussionmentioning
confidence: 88%
“…In conditions of ventricular pacing as well, TVI looks best suited to a function of ejection confirmation aimed at increasing the reliability of the pacing system, rather than to the continuous measurement of the pacing threshold required for the fine regulation of pulse energy [ 4 , 12 ]. Indeed, the TVI fluctuation follows the time-course of ventricular contraction and relaxation and is therefore a slow signal, which must be sampled for some hundreds of milliseconds to state whether the ejection is taking place or not [ 15 , 17 , 18 ]. In case of a negative result, the diagnosis is available too late to deliver a high energy back-up pulse within the current cardiac cycle.…”
Section: Discussionmentioning
confidence: 99%
“…The impedance recorded in transvalvular configuration between the right atrium and ventricle (TVI) allows precise beat‐to‐beat ejection surveillance. Systolic reduction in ventricular volume results in a clear‐cut TVI increase and the diastolic filling results in a gradual TVI decrease back to baseline 78–81 . As noted above, the peak–peak amplitude of cyclic TVI fluctuation reflects stroke volume 33,78,82 and is correlated with the velocity‐time integral of pulmonary outflow 78,83 .…”
Section: Sensors As a Potential Aid In Heart Failure Managementmentioning
confidence: 94%
“…This lack of information is partially explained by the greater attention generally paid to left heart haemodynamics, but can also result from the limited echocardiographic methods available for RV evaluation. TVI recording can be considered as a potential practical alternative, as the waveform is sensitive to the RV mechanical activity and can easily be derived by means of standard pacing leads during the implantation procedure, as well as in the follow-up of permanent implants [15][16][17] . The present study demonstrates that the TVI signal is strongly affected by RV pacing in some patients and not in others.…”
Section: Right Ventricular Activitymentioning
confidence: 99%
“…In addition, the transvalvular impedance (TVI) waveform was recorded. TVI, the electrical impedance derived between the right atrium and ventricle, changes during the cardiac cycle in a fashion strongly suggesting a correlation with RV ejection and filling [15][16][17] . TVI waveform analysis could therefore provide insight into pacing-induced modifications in RV mechanical activity, which is generally difficult to assess with conventional echocardiographic techniques.…”
Section: Introductionmentioning
confidence: 99%