Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure Patients

The rate adaptive sensors applied to cardiac pacing should respond as promptly as the normal sinus node with an highly specific and sensitive detection of the need of increasing heart rate. Sensors operating alone may not provide optimal heart responsiveness: central venous pH sensing, variations i...

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Main Authors: Eraldo Occhetta, Miriam Bortnik, Paolo Marino
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.4061/2011/925653
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author Eraldo Occhetta
Miriam Bortnik
Paolo Marino
author_facet Eraldo Occhetta
Miriam Bortnik
Paolo Marino
author_sort Eraldo Occhetta
collection DOAJ
description The rate adaptive sensors applied to cardiac pacing should respond as promptly as the normal sinus node with an highly specific and sensitive detection of the need of increasing heart rate. Sensors operating alone may not provide optimal heart responsiveness: central venous pH sensing, variations in the oxygen content of mixed venous blood, QT interval, breathing rate and pulmonary minute ventilation monitored by thoracic impedance variations, activity sensors. Using sensors that have different attributes but that work in a complementary manners offers distinct advantages. However, complicated sensors interactions may occur. Hemodynamic sensors detect changes in the hemodynamic performances of the heart, which partially depends on the autonomic nervous system-induced inotropic regulation of myocardial fibers. Specific hemodynamic sensors have been designed to measure different expression of the cardiac contraction strength: Peak Endocardial Acceleration (PEA), Closed Loop Stimulation (CLS) and TransValvular Impedance (TVI), guided by intraventricular impedance variations. Rate-responsive pacing is just one of the potential applications of hemodynamic sensors in implantable pacemakers. Other issues discussed in the paper include: hemodynamic monitoring for the optimal programmation and follow up of patients with cardiac resynchronization therapy; hemodynamic deterioration impact of tachyarrhythmias; hemodynamic upper rate limit control; monitoring and prevention of vasovagal malignant syncopes.
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spelling doaj-art-5b3c6817e2e54a1aa5cc366e9c110db12025-08-20T03:35:01ZengWileyCardiology Research and Practice2090-05972011-01-01201110.4061/2011/925653925653Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure PatientsEraldo Occhetta0Miriam Bortnik1Paolo Marino2Dipartimento Cardiologico, AOU Maggiore della Carità, Corso Mazzini 18, 28100 Novara, ItalyDipartimento Cardiologico, AOU Maggiore della Carità, Corso Mazzini 18, 28100 Novara, ItalyDipartimento Cardiologico, AOU Maggiore della Carità, Corso Mazzini 18, 28100 Novara, ItalyThe rate adaptive sensors applied to cardiac pacing should respond as promptly as the normal sinus node with an highly specific and sensitive detection of the need of increasing heart rate. Sensors operating alone may not provide optimal heart responsiveness: central venous pH sensing, variations in the oxygen content of mixed venous blood, QT interval, breathing rate and pulmonary minute ventilation monitored by thoracic impedance variations, activity sensors. Using sensors that have different attributes but that work in a complementary manners offers distinct advantages. However, complicated sensors interactions may occur. Hemodynamic sensors detect changes in the hemodynamic performances of the heart, which partially depends on the autonomic nervous system-induced inotropic regulation of myocardial fibers. Specific hemodynamic sensors have been designed to measure different expression of the cardiac contraction strength: Peak Endocardial Acceleration (PEA), Closed Loop Stimulation (CLS) and TransValvular Impedance (TVI), guided by intraventricular impedance variations. Rate-responsive pacing is just one of the potential applications of hemodynamic sensors in implantable pacemakers. Other issues discussed in the paper include: hemodynamic monitoring for the optimal programmation and follow up of patients with cardiac resynchronization therapy; hemodynamic deterioration impact of tachyarrhythmias; hemodynamic upper rate limit control; monitoring and prevention of vasovagal malignant syncopes.http://dx.doi.org/10.4061/2011/925653
spellingShingle Eraldo Occhetta
Miriam Bortnik
Paolo Marino
Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure Patients
Cardiology Research and Practice
title Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure Patients
title_full Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure Patients
title_fullStr Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure Patients
title_full_unstemmed Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure Patients
title_short Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure Patients
title_sort usefulness of hemodynamic sensors for physiologic cardiac pacing in heart failure patients
url http://dx.doi.org/10.4061/2011/925653
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