Abstract：
BACKGROUND:Invasively measured maximum increase in left ventricular pressure (LV dP/dtmax) has been used to assess biventricular (BiV) pacing. We quantified extracardiac factors contributing to its variability, and developed a protocol to minimize these effects in an acute pacing experiment. METHODS AND RESULTS:Continuous pressure was recorded by a guidewire sensor placed in the LV. Four to six test pacing interventions were performed, each repeated 3 times and followed by a baseline pacing configuration. Maximum increase in LV dP/dtmax from any measurement of BiV pacing was median 20.3% in 25 patients, compared with BiV pacing off. When directly comparing sequential measurements with BiV pacing on and off, median increase was 7.4%. Noncardiac sources of modulation included respiratory variation (6.4%), drift from first to last baseline measurement (5.0%), and discrepancy among repeated recordings of the same pacing intervention (3.3%). Comparing test interventions to interleaved baseline measurements reduced discrepancy among recordings to 2.1%; P < .001. CONCLUSIONS:With repeated measurements of baseline state, and by comparing test interventions only to baseline measurements performed before and after, it is possible to minimize extracardiac factors and focus on the effects of test pacing interventions.
journal_name
J Card Failjournal_title
Journal of cardiac failureauthors
Thibault B,Dubuc M,Karst E,Andrade J,Dyrda K,Guerra PG,Macle L,Rivard L,Roy D,Talajic M,Ryu K,Farazi TG,Varma N,Khairy Pdoi
10.1016/j.cardfail.2014.01.020subject
Has Abstractpub_date
2014-05-01 00:00:00pages
365-72issue
5eissn
1071-9164issn
1532-8414pii
S1071-9164(14)00063-3journal_volume
20pub_type
杂志文章abstract：BACKGROUND:Studies have shown that neither ejection fraction nor hemodynamic abnormalities during exercise in chronic heart failure (HF) correlate with symptoms of fatigue and exhaustion. The concept that exercise limitation in patients with chronic HF is due to abnormal hemodynamics during exercise has been revised to...
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pub_type： 杂志文章,多中心研究
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