The University of Southampton
University of Southampton Institutional Repository

Left and right parasternal sensing for the S-ICD in adult congenital heart disease patients and normal controls

Left and right parasternal sensing for the S-ICD in adult congenital heart disease patients and normal controls
Left and right parasternal sensing for the S-ICD in adult congenital heart disease patients and normal controls
Background - This study investigated the impact of a right parasternal sensing electrode position on the R- and T-wave amplitudes and the R:T ratio in three subcutaneous implantable cardioverter defibrillator (S-ICD) vectors in patients with adult congenital heart disease (ACHD) and normal controls.

Methods - Conventional left parasternal sensing electrode position and right parasternal sensing electrode positions were used to collect 10-second electrograms, recorded through an 80-electrode body surface mapping technology (Prime ECG™ system, Heartscape Technologies Inc., now Verathon, Columbia, MD, USA). Recordings were made in the supine, prone, left lateral, right lateral, sitting, and standing positions in using both the standard electrode vector position and the right parasternal positions.

Results - Forty patients were recruited and 37 patients were used for analysis. Twenty-seven (73%) had complex ACHD; 10 patients had normal hearts and acted as controls. A total of 3,708 data points were analyzed. There were no significant differences in the R:T ratio when measured in ACHD patients in the right compared to the left parasternal lead position. In contrast, there were important differences in the magnitude of the R:T ratio when measured in control patients in the right compared to the left parasternal lead position; in the primary vector, the R:T ratio was greater in right than left by 2.99 (P = 0.0002; 95% confidence interval [CI]: 1.48–4.50) and in the secondary vector, the R:T ratio was smaller in the right than in the left by 0.77 (P = 0.004; 95% CI: ?1.58–0.05).

Conclusion - In selected patients, a right parasternal lead position may provide a useful alternative sensing configuration for the S-ICD.
282-290
Wilson, D.G.
49b1d5e6-a489-4f13-a575-68248b49d1f9
Zeb, M.
469fda8e-8318-4fe5-97f3-a46eec60f333
Veldtman, G.
17aa0d1b-f2ce-4009-af73-049cde18d676
Dimitrov, B.D.
366d715f-ffd9-45a1-8415-65de5488472f
Morgan, J.M.
7bd04ada-ca61-4a2c-b1cf-1750ffa9d89c
Wilson, D.G.
49b1d5e6-a489-4f13-a575-68248b49d1f9
Zeb, M.
469fda8e-8318-4fe5-97f3-a46eec60f333
Veldtman, G.
17aa0d1b-f2ce-4009-af73-049cde18d676
Dimitrov, B.D.
366d715f-ffd9-45a1-8415-65de5488472f
Morgan, J.M.
7bd04ada-ca61-4a2c-b1cf-1750ffa9d89c

Wilson, D.G., Zeb, M., Veldtman, G., Dimitrov, B.D. and Morgan, J.M. (2016) Left and right parasternal sensing for the S-ICD in adult congenital heart disease patients and normal controls. PACE Pacing and Clinical Electrophysiology, 39 (3), 282-290. (doi:10.1111/pace.12802). (PMID:26694691)

Record type: Article

Abstract

Background - This study investigated the impact of a right parasternal sensing electrode position on the R- and T-wave amplitudes and the R:T ratio in three subcutaneous implantable cardioverter defibrillator (S-ICD) vectors in patients with adult congenital heart disease (ACHD) and normal controls.

Methods - Conventional left parasternal sensing electrode position and right parasternal sensing electrode positions were used to collect 10-second electrograms, recorded through an 80-electrode body surface mapping technology (Prime ECG™ system, Heartscape Technologies Inc., now Verathon, Columbia, MD, USA). Recordings were made in the supine, prone, left lateral, right lateral, sitting, and standing positions in using both the standard electrode vector position and the right parasternal positions.

Results - Forty patients were recruited and 37 patients were used for analysis. Twenty-seven (73%) had complex ACHD; 10 patients had normal hearts and acted as controls. A total of 3,708 data points were analyzed. There were no significant differences in the R:T ratio when measured in ACHD patients in the right compared to the left parasternal lead position. In contrast, there were important differences in the magnitude of the R:T ratio when measured in control patients in the right compared to the left parasternal lead position; in the primary vector, the R:T ratio was greater in right than left by 2.99 (P = 0.0002; 95% confidence interval [CI]: 1.48–4.50) and in the secondary vector, the R:T ratio was smaller in the right than in the left by 0.77 (P = 0.004; 95% CI: ?1.58–0.05).

Conclusion - In selected patients, a right parasternal lead position may provide a useful alternative sensing configuration for the S-ICD.

Text
pace12802-pbd.pdf - Version of Record
Restricted to Repository staff only
Request a copy

More information

Accepted/In Press date: 11 December 2015
e-pub ahead of print date: 23 December 2015
Published date: 21 January 2016
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 397526
URI: http://eprints.soton.ac.uk/id/eprint/397526
PURE UUID: 55f02df2-38f9-42db-989c-240eb4468599

Catalogue record

Date deposited: 24 Nov 2016 14:54
Last modified: 16 Dec 2019 19:50

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×