Accelerometer-based atrioventricular synchronous pacing with a ventricular leadless pacemaker: Results from the Micra atrioventricular feasibility studies
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
PubMed
29758405
DOI
10.1016/j.hrthm.2018.05.004
PII: S1547-5271(18)30470-3
Knihovny.cz E-zdroje
- Klíčová slova
- Accelerometer, Atrial contraction, Atrioventricular block, Atrioventricular synchronous pacing, Leadless pacemaker,
- MeSH
- akcelerometrie přístrojové vybavení MeSH
- atrioventrikulární blokáda patofyziologie terapie MeSH
- design vybavení MeSH
- dospělí MeSH
- elektrokardiografie metody MeSH
- kardiostimulátor * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- následné studie MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční frekvence fyziologie MeSH
- srdeční komory patofyziologie MeSH
- srdeční síně patofyziologie MeSH
- studie proveditelnosti MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: Micra is a leadless pacemaker that is implanted in the right ventricle and provides rate response via a 3-axis accelerometer (ACC). Custom software was developed to detect atrial contraction using the ACC enabling atrioventricular (AV) synchronous pacing. OBJECTIVE: The purpose of this study was to sense atrial contractions from the Micra ACC signal and provide AV synchronous pacing. METHODS: The Micra Accelerometer Sensor Sub-Study (MASS) and MASS2 early feasibility studies showed intracardiac accelerations related to atrial contraction can be measured via ACC in the Micra leadless pacemaker. The Micra Atrial TRacking Using A Ventricular AccELerometer (MARVEL) study was a prospective multicenter study designed to characterize the closed-loop performance of an AV synchronous algorithm downloaded into previously implanted Micra devices. Atrioventricular synchrony (AVS) was measured during 30 minutes of rest and during VVI pacing. AVS was defined as a P wave visible on surface ECG followed by a ventricular event <300 ms. RESULTS: A total of 64 patients completed the MARVEL study procedure at 12 centers in 9 countries. Patients were implanted with a Micra for a median of 6.0 months (range 0-41.4). High-degree AV block was present in 33 patients, whereas 31 had predominantly intrinsic conduction during the study. Average AVS during AV algorithm pacing was 87.0% (95% confidence interval 81.8%-90.9%), 80.0% in high-degree block patients and 94.4% in patients with intrinsic conduction. AVS was significantly greater (P <.001) during AV algorithm pacing compared to VVI in high-degree block patients, whereas AVS was maintained in patients with intrinsic conduction. CONCLUSION: Accelerometer-based atrial sensing is feasible and significantly improves AVS in patients with AV block and a single-chamber leadless pacemaker implanted in the right ventricle.
Baptist Hospital of Miami Miami Florida
CHU de Tours Chambray les Tours France
GVM Care and Research Lamezia Terma Italy
Hopital Du Haut Leveque Pessac France
Hospital Clinic Universitat de Barcelona Barcelona Spain
Institut Jantung Negara Selangor Malaysia
Medtronic plc Mounds View Minnesota
Military Hospital State Health Center Budapest Hungary
Na Homolce Hospital Prague Czech Republic
NYU Langone Medical Center New York New York
Odense University Hospital Odense Denmark
Southern Heart Group Jacksonville Florida
Citace poskytuje Crossref.org
ClinicalTrials.gov
NCT02930980, NCT03157297
