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• W4377012860 abstract "Few hemodynamic sensors in implantable devices are available on the market. We built a sensor for myocardial contraction detection that could be easily integrated in the cardiac leads. The purpose of this study was to evaluate the possibility of detecting VF in patients utilizing the cardiomechanic sensor based upon high frequency (HF) reflection coefficient measurements on standard ICD leads. Such measurement yields the lead bending signal caused by myocardial contraction and could assist in VF detection utilizing just a standard ICD lead. We performed HF measurements in 16 patients undergoing ICD implantation or replacement. DFT testing was mandatory in this group of patients. A custom-designed directional coupler was used to connect the pacing/sensing conductor of the ICD lead to the FieldFox RF analyzer model N9912A (Agilent, USA) and in parallel with ICD. The calibration procedure was done at 50 MHz. There was no interference between the RF analyzer and the ICDs during sensing nor during shock. A VF episode was induced and defibrillation was done utilizing an ICD inserted within. ECG, ventricular IEGM, HF signal, and chest X-ray fluoroscopy were synchronously recorded during the DFT test. RF analyzer, Medtronic 2090 programmer outputs, and blood pressure monitor were connected to the data acquisition input of the DELL workstation for recording and further analysis. We were able to record the HF reflection signal caused by the lead bending in all patients. The figure illustrates three signals during the DFT testing: HF reflection coefficient (top), blood pressure (middle), and IEGM (bottom). In sinus rhythm, HF signals lag after the QRS wave synchronously with the blood pressure wave as they represent the lead bending due to the cardiac contraction. Shock on T induction was successful. Blood pressure drops down instantly upon the VF induction and the HF signal amplitude decreases and shows a waveform representative of ventricular quivering. Defibrillation restores the sinus rhythm, blood pressure, and HF signal. We showed the feasibility of using HF reflection signal to identify VF and differentiate from sinus rhythm during DFT testing. Our system can be used with any bipolar lead without modification of lead or connector. The implantable device design should be significantly modified to incorporate the HF circuit and chronic studies should be performed. Further applications in CRT optimization should be investigated." @default.
• W4377012860 created "2023-05-19" @default.
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• W4377012860 date "2023-05-01" @default.
• W4377012860 modified "2023-09-26" @default.
• W4377012860 title "PO-05-108 CARDIOMECHANIC SENSOR FOR VF DETECTION" @default.
• W4377012860 doi "https://doi.org/10.1016/j.hrthm.2023.03.1503" @default.
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