Predictor of A4-amplitude using preprocedural electrocardiography in patients with leadless pacemakers.
Electrocardiography
Leadless pacemaker
Maximum deflection index
Mechanical atrial sensing
P-wave dispersion
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
19 Feb 2024
19 Feb 2024
Historique:
received:
18
12
2023
revised:
31
01
2024
accepted:
13
02
2024
medline:
22
2
2024
pubmed:
22
2
2024
entrez:
21
2
2024
Statut:
aheadofprint
Résumé
Based on the historical studies of leadless pacemakers (LP), high atrio-ventricular synchrony (AVS) with mechanical sensing-based VDD pacing is largely influenced by A4-amplitude. A limited study investigated the predictors of A4-amplitude using clinical and echocardiographic parameters. This study aimed to investigate the predictors of A4-amplitude preoperatively to select patients who could benefit the most from AVS among patients with VDD LPs (Micra-AV, Medtronic). Data from patients who received Micra-AV implantations from November 2021 to August 2023 at Tottori University Hospital were analyzed. Twelve-lead electrocardiography and transthoracic echocardiography were performed before the Micra-AV implantations. To assess the electrical indices associated with the A4-signal, the electrocardiographic morphological P-wave parameters were analyzed including the P-wave duration, P-wave amplitude, maximum deflection index (MDI), and P-wave dispersion. A total of 50 patients who underwent Micra-AV implantations (median age, 84 years; 64% male) were included and divided into two groups based on the median value of A4-amplitude, the high-A4 group (A4-amplitude >2.5m/s Preoperative electrocardiographic evaluations of the P-wave morphology may be useful for predicting A4-amplitude. The MDI was the only independent A4-amplitude predictor that seemed promising for selecting Micra-AV patients.
Sections du résumé
BACKGROUND
BACKGROUND
Based on the historical studies of leadless pacemakers (LP), high atrio-ventricular synchrony (AVS) with mechanical sensing-based VDD pacing is largely influenced by A4-amplitude. A limited study investigated the predictors of A4-amplitude using clinical and echocardiographic parameters.
OBJECTIVE
OBJECTIVE
This study aimed to investigate the predictors of A4-amplitude preoperatively to select patients who could benefit the most from AVS among patients with VDD LPs (Micra-AV, Medtronic).
METHODS
METHODS
Data from patients who received Micra-AV implantations from November 2021 to August 2023 at Tottori University Hospital were analyzed. Twelve-lead electrocardiography and transthoracic echocardiography were performed before the Micra-AV implantations. To assess the electrical indices associated with the A4-signal, the electrocardiographic morphological P-wave parameters were analyzed including the P-wave duration, P-wave amplitude, maximum deflection index (MDI), and P-wave dispersion.
RESULTS
RESULTS
A total of 50 patients who underwent Micra-AV implantations (median age, 84 years; 64% male) were included and divided into two groups based on the median value of A4-amplitude, the high-A4 group (A4-amplitude >2.5m/s
CONCLUSION
CONCLUSIONS
Preoperative electrocardiographic evaluations of the P-wave morphology may be useful for predicting A4-amplitude. The MDI was the only independent A4-amplitude predictor that seemed promising for selecting Micra-AV patients.
Identifiants
pubmed: 38382683
pii: S1547-5271(24)00205-4
doi: 10.1016/j.hrthm.2024.02.033
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.