Journal Article

Can transventricular intracardiac impedance measurement discriminate haemodynamically unstable ventricular arrhythmias in human?

Gerry Kaye, Deborah Edgar, Telal Mudawi, Michael Lippert and Gerald Czygan

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 2, pages 122-126
Published in print February 2007 | ISSN: 1099-5129
Published online February 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eul150
Can transventricular intracardiac impedance measurement discriminate haemodynamically unstable ventricular arrhythmias in human?

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Aims To measure changes in transventricular impedance during arrhythmias.

Methods and results Patients were studied during electrophysiological studies. A quadrapolar catheter was positioned at the right ventricular apex (RVA) and a decapolar catheter within the coronary sinus (CS). Transventricular impedance was measured by injecting a subthreshold biphasic rectangular pulse of 600 µ A between poles 1 of the CS catheter and pole 1 of the RVA catheter and the voltage measured between CS pole 10 and RVA catheter pole 4. Stroke impedance (SZ), surface ECG, intracardiac electrogram (IEGM), and invasive femoral artery blood pressure (FAP) were recorded. Twenty-eight patients were analysed, 5 with inducible, haemodynamically unstable ventricular tachycardia (VT) (HUSVT), 5 with stable VT (HSVT). During HUSVT, the SZ value reduced to 22% (range 0.15–0.32 P < 0.001) in comparison with sinus rhythm. For HSVT, the SZ value reduced to 58% (range 0.33–0.88) P < 0.01, significantly different from HUSVT (P < 0.01). There was a good correlation between reduction of SZ and arterial pulse pressure (PP) during arrhythmias (r = 0.95).

Conclusion Changes in SZ strongly correlated with PP amplitude. Transventricular impedance fell significantly during unstable arrhythmias and may be useful as a sensor capable of haemodynamic discrimination.

Keywords: Transventricular intracardiac impedance; Ventricular tachycardia; Haemodynamic stability

Journal Article.  2959 words.  Illustrated.

Subjects: Cardiovascular Medicine

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