Archives

  • 2018-07
  • 2018-10
  • 2018-11
  • 2019-04
  • 2019-05
  • 2019-06
  • 2019-07
  • 2019-08
  • 2019-09
  • 2019-10
  • 2019-11
  • 2019-12
  • 2020-01
  • 2020-02
  • 2020-03
  • 2020-04
  • 2020-05
  • 2020-06
  • 2020-07
  • 2020-08
  • 2020-09
  • 2020-10
  • 2020-11
  • 2020-12
  • 2021-01
  • 2021-02
  • 2021-03
  • 2021-04
  • 2021-05
  • 2021-06
  • 2021-07
  • 2021-08
  • 2021-09
  • 2021-10
  • 2021-11
  • 2021-12
  • 2022-01
  • 2022-02
  • 2022-03
  • 2022-04
  • 2022-05
  • 2022-06
  • 2022-07
  • 2022-08
  • 2022-09
  • 2022-10
  • 2022-11
  • 2022-12
  • 2023-01
  • 2023-02
  • 2023-03
  • 2023-04
  • 2023-05
  • 2023-06
  • 2023-08
  • 2023-09
  • 2023-10
  • 2023-11
  • 2023-12
  • 2024-01
  • 2024-02
  • 2024-03
  • br Sensors for HF monitoring can

    2019-05-20


    Sensors for HF monitoring can be classified according to the technical instrumentation. Table 2 summarizes the sensors that have been used or proposed to monitor the events of HF. The paced QRS enables the determination of the QT duration. In addition, the QRS width, measured as the ventricular depolarization gradient, has been proposed as a sensitive marker of catecholamine [16]. These sensors have long been used as surrogate markers of sympathetic activity, which increases with exercise. High percentage of biventricular pacing is necessary to deliver effective CRT [17] and is a good marker of HF decompensation. AF and ventricular tachyarrhythmias can either be a consequence or trigger event of HF that can easily be recognized and treated. Heart rate variability (HRV) can be measured in patients not yet rendered pacing-dependent, and this factor is a well-established prognostic marker because it reflects the level of sympathovagal imbalance [18]. Reduction of HRV antedates HF events.
    Combined melk inhibitor failure diagnostics The Program to Access and Review Trending Information and Evaluate Correlation to Symptoms in Patients with HF (PARTNERS HF) is an observational study on the use of diagnostics to predict HF [72]. Hundred sites in the US prospectively recruited 694 patients implanted with CRT-D and followed them for 11.7±2 months. Table 5 shows the diagnostic data considered important in an algorithm to predict ADHF. Ninety patients had 141 adjudicated HF events, occurring after 60 days of implantation. A positive combined diagnostic set predicts a 5.5-fold risk of hospitalization in the next month, even after adjusting for the clinical variables. The main diagnostic parameters are OptiVol ≥ 60Ω. day, low activity, and HRV. When additional OptiVol was ≥100 (28% of patients), it was also predictive of ADHF (Fig. 8). Further sub-group analysis suggested that the specificity of ADHF is improved with setting a higher level of fluid index, and using more non-fluid related indices (at the expense of some loss of specificity.) There is an improvement in the diagnostic accuracy if sampling is performed every 15 days versus less frequently. Further tests are required to verify whether closer monitoring, such as with the use of remote web-based system, can further reduce ADHF.
    Conclusion
    Conflict of interest
    Introduction Implantable cardiac monitoring devices are a useful and reliable means of diagnosing atrial tachycardia and atrial fibrillation (AT/AF) in clinical practice. The yearly incidence of symptomatic or asymptomatic paroxysmal AT/AF diagnosed by pacemakers may exceed 50% [1–6]. Current guidelines recommend long-term anticoagulation therapy in patients with non-rheumatic, paroxysmal, or permanent AF and risk factors. The lowest atrial rate and duration of AT/AF (as detected by implantable monitoring devices) associated with an increased risk of thromboembolisms have not yet been defined. In one study, brief episodes of paroxysmal AF (often <30s in duration) recorded during a mean of 22.6h of ambulatory electrocardiographic monitoring were found to be associated with acute and chronic brain infarcts on brain imaging; the lesions were cortical, in particular, and the findings were consistent with embolisms [7]. The importance of very brief episodes of AT/AF was confirmed by the asymptomatic atrial fibrillation and Stroke Evaluation in pacemaker patients and the atrial fibrillation Reduction atrial pacing Trial (ASSERT) [8]. In that trial, over a mean follow-up period of 2.8 years (1) episodes of AT/AF lasting >6min at a rate >190bpm were detected by the atrial high-rate episode (AHRE) function in 36% of 2580 pacemaker or implantable defibrillator recipients who had no history of AT/AF before device implantation, and (2) patients with AT/AF detected by the AHRE function were found to have a 2.5-fold higher incidence of ischemic strokes or systemic embolisms than those without [8,9]. Notably, among pacemaker recipients without a history of AT/AF, 35% of all strokes or systemic embolisms were preceded by AT/AF detected by the pacemaker [9]. Therefore, an accurate identification of AT/AF allows the planning of optimal antiarrhythmic and antithrombotic therapy [3].