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Detection and hemodynamic significance of cardiac pacemaker-induced phrenic nerve stimulation

Zuber, Michel and Roos, Markus and Kobza, Richard and Toggweiler, Stefan and Meier, Rolf and Erne, Paul. (2010) Detection and hemodynamic significance of cardiac pacemaker-induced phrenic nerve stimulation. Congestive heart failure, Vol. 16, H. 4. pp. 147-152.

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Official URL: http://edoc.unibas.ch/dok/A6006672

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Abstract

The authors investigated acoustic cardiography, the digital analysis of electrocardiogram (ECG) and heart sounds, to detect phrenic nerve stimulation (PNS) and assess its hemodynamic significance. They studied 42 patients and induced 46 instances of PNS induced through cardiac pacing at various locations in the heart. These 46 instances of PNS were either independently documented using fluoroscopy or were symptomatic. The authors collected acoustic cardiography data including the electromechanical activation time (interval from Q onset to the first heart sound [S1]) as a percentage of the RR interval (%EMAT) to assess systolic function. Acoustic cardiography provided evidence of PNS when it occurred. They also found significant %EMAT prolongation when right ventricular pacing was associated with PNS (Delta%EMAT=2.7, P=.012), but none beyond the normal range with right ventricular pacing in the absence of PNS. Documented PNS occurred in 33 episodes (60%) in patients with noticeable symptoms. Stimulation amplitudes could be found that generated asymptomatic PNS for all of the five participants explicitly tested for it. PNS can be asymptomatic. PNS due to right ventricular pacing is associated with impaired left ventricular systolic function. Acoustic cardiography is an effective method of detecting and assessing the hemodynamic significance of pacemaker-related PNS.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Further Research Groups at DBM > Signal Transduction (Resink/Erne)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie
UniBasel Contributors:Zuber, Michel and Erne, Paul
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Blackwell
ISSN:1527-5299
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:19 Jul 2013 07:43
Deposited On:19 Jul 2013 07:36

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