R-Wave Sensing in an Implantable Cardiac Monitor without ECG-Based Preimplant Mapping: Results from a Multicenter Clinical Trial.
In: Pacing & Clinical Electrophysiology, Jg. 37 (2014-04-01), Heft 4, S. 505-511
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Zugriff:
Introduction Reducing the form factor of an implantable cardiac monitor (ICM) may simplify device implant. This study evaluated R-wave sensing at a range of electrode distances and a preferred device implant location without mapping. Methods Patients scheduled for a Medtronic Reveal® ICM implant (Medtronic Inc., Minneapolis, MN, USA) underwent a preimplant pocket recording using a diagnostic recording catheter. The ICM implant location was left to the discretion of the implanting physician, but a 'recommended' position spanned the V 2 -V 3 electrocardiogram electrode location in an oblique 45° angle. R-wave amplitudes were analyzed from ICM follow-up. Results Seventeen of 41 subjects (15 male, age 57 ± 16 years) had the maximum surface-filtered R-wave at the recommended location. Fourteen patients underwent diagnostic recording across the range of electrode spacing. There was a strong correlation between the R-wave amplitude and electrode distance (r 2 = 0.97, P < 0.001) with an increase of 29 μV per 2.5 mm. Comparing normalized R-wave distributions between the recommended ICM implant group (Group 1, n = 19) and the remaining patients (Group 2, n = 7), the proportion of ICM R-wave counts of amplitude 0.25-1.2 mV was higher (79% vs 46%, P < 0.05). Of 17 patients in Group 1 who had ≥1-month ICM follow-up (79 ± 45 days), no sensing-related false arrhythmia detection was found in 16 (93%) patients. Conclusions The subcutaneous R-wave amplitude correlates with electrode spacing in the implant zone of ICM patients. Implant locations at the V 2 -V 3 position at a 45° angle offer an adequate R wave for sensing. Preimplant mapping to achieve acceptable R-wave amplitude may not be necessary. [ABSTRACT FROM AUTHOR]
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R-Wave Sensing in an Implantable Cardiac Monitor without ECG-Based Preimplant Mapping: Results from a Multicenter Clinical Trial.
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Autor/in / Beteiligte Person: | KRAHN, ANDREW D. ; PICKETT, ROBERT A. ; SAKAGUCHI, SCOTT ; SHAIK, NAUSHAD ; CAO, JIAN ; NORMAN, HOLLY S. ; GUERRERO, PATRICIA |
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Zeitschrift: | Pacing & Clinical Electrophysiology, Jg. 37 (2014-04-01), Heft 4, S. 505-511 |
Veröffentlichung: | 2014 |
Medientyp: | academicJournal |
ISSN: | 0147-8389 (print) |
DOI: | 10.1111/pace.12303 |
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