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34 results on '"resynchronisation therapy"'

2. Capture threshold of bipolar and unipolar pacing of left ventricle via coronary sinus branch: longitudinal study

Author

Jakub Stritecky, Jan Kremlacek, Josef Hanus, Ludek Haman, Hana Stritecka, Jakub Simka, and Petr Parizek

Subjects
quadripolar lead, pacing capture threshold energy, pacing polarity, steroid eluting lead, resynchronisation therapy, battery longevity, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

IntroductionThe aim of this paper is to first monitor the changes in the capture threshold of endovascularly placed leads for left ventricle pacing, second to compare the pacing configurations, and third to verify the effect of Steroid elution for endovascular leads.Sample and MethodThe study included 202 consecutive single centre patients implanted with the Quartet™ lead (St. Jude Medical). The capture threshold and related lead parameters were tested during implantation, on the day of the patient’s discharge, and 3, 9, and 15 months after implantation. The electrical energy corresponding to the threshold values for inducing ventricular contraction was recorded for subgroups of patients with bipolar and pseudo-unipolar pacing vectors and electrodes equipped with and without a slow-eluting steroids. The best setting for the resynchronization effect was generally chosen. Capture threshold was taken as a selection criterion only if there were multiple options with (expected) similar resynchronization effect.Results and DiscussionThe measurements showed that the ratio of threshold energies of UNI vs. BI was 5× higher (p

Published
2023
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3. Benchmarking Belgian CRT practice against the rest of Europe: insights from the ESC-CRT survey II.

Author

Gauthey, Anaïs, Willems, Rik, Vandekerckhove, Yves, Mullens, Wilfried, Stefan, Liliana, Carryn, Xavier, Blommaert, Dominique, Mairesse, Georges, Dickstein, Kenneth, Normand, Camilla, Linde, Cecilia, and Le Polain de Waroux, Jean-Benoît

Subjects
BENCHMARKING (Management), HEART failure, CARDIOVASCULAR diseases, ELECTRONIC equipment, PACEMAKER cells
Abstract

This subanalysis of the Euro-CRT survey II specifically focus on Belgian practice for CRT implantation. It explores Belgian adherence with the guidelines but also benchmark CRT practice in Belgium against the other European countries. Overall, Belgian management of CRT implantation is performed with great agreement with guidelines. This report could be used to provide guidance for both practical and economical approaches. [ABSTRACT FROM AUTHOR]

Published
2020
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4. Editorial: Novelties in the therapeutic approaches for chronic heart failure: cardiovascular targets and beyond, volume II.

Author

Iacoviello M, Sorgente A, and Passantino A

Abstract

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Published
2023
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5. Capture threshold of bipolar and unipolar pacing of left ventricle via coronary sinus branch: longitudinal study.

Author

Stritecky J, Kremlacek J, Hanus J, Haman L, Stritecka H, Simka J, and Parizek P

Abstract

Introduction: The aim of this paper is to first monitor the changes in the capture threshold of endovascularly placed leads for left ventricle pacing, second to compare the pacing configurations, and third to verify the effect of Steroid elution for endovascular leads., Sample and Method: The study included 202 consecutive single centre patients implanted with the Quartet™ lead (St. Jude Medical). The capture threshold and related lead parameters were tested during implantation, on the day of the patient's discharge, and 3, 9, and 15 months after implantation. The electrical energy corresponding to the threshold values for inducing ventricular contraction was recorded for subgroups of patients with bipolar and pseudo-unipolar pacing vectors and electrodes equipped with and without a slow-eluting steroids. The best setting for the resynchronization effect was generally chosen. Capture threshold was taken as a selection criterion only if there were multiple options with (expected) similar resynchronization effect., Results and Discussion: The measurements showed that the ratio of threshold energies of UNI vs. BI was 5× higher ( p  < 0.001) at implantation. At the end of the follow-up, it dropped to 2.6 ( p  = 0.012). The steroid effect in BI vectors was caused by a double capture threshold in the NSE group compared to the SE group ( p  < 0.001), increased by approximately 2.5 times ( p  < 0.001). The study concludes that after a larger initial increase in the capture threshold, the leads showed a gradual increase in the entire set. As a result, the bipolar threshold energies increase, and the pseudo-unipolar energies decrease. Since bipolar vectors require a significantly lower pacing energy, battery life of the implanted device would improve. When evaluating the steroid elution of bipolar vectors, we observe a significant positive effect of a gradual increase of the threshold energy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Stritecky, Kremlacek, Hanus, Haman, Stritecka, Simka and Parizek.)

Published
2023
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6. Resynchronisation therapy in patients with heart failure: Our results

Author

Milašinović Goran, Jelić Vera, Petrović Milan, Ćalović Žarko, Savić Dragutin, Pavlović Siniša U., Živković Mirjana, and Kanjuh Vladimir

Subjects
heart failure, prolonged QRS interval, resynchronisation therapy, Medicine
Abstract

INTRODUCTION. Resynchronisation therapy with biventricular permanent pacing stimulation is one method of treating patients with systolic heart failure, with echocardiograph signs of ventricular asynchrony and a prolonged QRS of longer than 120 milliseconds. This method has been accepted in most medical centers around the world and was instigated in our Pacemaker Centre in December 2001, 3 months after FDA approval for human use. OBJECTIVE. The aim of the study was to present this new procedure and the results obtained from our own group of patients. METHOD. A multi-site, biventricular pacemaker, with a special electrode for left-half heart stimulation was implanted in the coronary sinus of 17 patients who had suffered systolic heart failure (12 male and 5 female, average age 59.9 years). For all of them, the duration of the QRS interval was longer than 120 ms, with left bundle branch morphology, and an ejection fraction below 30%. All the patients were NYHA class II or III. Prior to and after the implantation, a 12-channel ECG and ECHO were carried out, a b-minute hall walk test was performed, additionally, the total walked distance on a flat surface was measured, the general condition of the patient was evaluated, the number of medications being taken was noted, as was the number of days of hospitalization. RESULTS. The average time from diagnosis to implantation was 22 months, and the average post-operative follow-up was 14 months. Two of the patients died 10 and 7 months after the implantation, due to a new myocardial infarction and refractory heart failure. In addition, one patient did not show any improvement after the implantation of the multi-site pacemaker (there were three "non-responder" patients). All the other patients felt much better: decreased NYHA class for I - II class, increased left ventricle ejection fraction, reduced use of diuretics, increased b-minute hall walk distance and general walk distance on a flat surface, and decreased number of days of hospitalization. CONCLUSION. Resynchronisation heart failure therapy in the majority of patients with systolic left ventricular dysfunction and a prolonged QRS interval considerably improves cardiac function, in addition to reducing symptoms and hospital stays.

Published
2005
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7. Benchmarking Belgian CRT practice against the rest of Europe: insights from the ESC-CRT survey II

Author

Anaïs Gauthey, Cecilia Linde, Georges H. Mairesse, Camilla Normand, Yves Vandekerckhove, Liliana Stefan, Kenneth Dickstein, Xavier Carryn, Wilfried Mullens, Rik Willems, Dominique Blommaert, Jean-Benoît le Polain de Waroux, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, UCL - (MGD) Service de cardiologie, and UCL - SSS/IREC/MONT - Pôle Mont Godinne

Subjects
Male, medicine.medical_specialty, heart failure, 030204 cardiovascular system & hematology, Cardiac Resynchronization Therapy, 03 medical and health sciences, 0302 clinical medicine, Belgium, Risk Factors, Surveys and Questionnaires, Rest (finance), Benchmark (surveying), medicine, Humans, Medical physics, 030212 general & internal medicine, Practice Patterns, Physicians', Cardiac device, Aged, Heart Failure, resynchronisation therapy, business.industry, cardiac device, General Medicine, Benchmarking, Europe, Treatment Outcome, CRT survey, Female, Cardiology and Cardiovascular Medicine, business, guidelines, CRT response
Abstract

This subanalysis of the Euro-CRT survey II specifically focus on Belgian practice for CRT implantation. It explores Belgian adherence with the guidelines but also benchmark CRT practice in Belgium against the other European countries. Overall, Belgian management of CRT implantation is performed with great agreement with guidelines. This report could be used to provide guidance for both practical and economical approaches.

Published
2019
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8. The impact of His bundle pacing on left ventricle global longitudinal strain in heart failure patients with LBBB – a pilot study

Author

Marija Brestovac, Jadranka Šeparović Hanževački, Martina Lovrić Benčić, and Richard Matasić

Subjects
medicine.medical_specialty, Longitudinal strain, business.industry, medicine.medical_treatment, Cardiac resynchronization therapy, medicine.disease, medicine.anatomical_structure, Ventricle, Internal medicine, Heart failure, Bundle, medicine, Cardiology, cardiovascular system, His bundle pacing, cardiac resynchronization therapy, global longitudinal strain, Cardiology and Cardiovascular Medicine, business, resynchronisation therapy
Abstract

Improvement of GLS was present in HBP-CRT as well as standard CRT. No significant difference was found between the two methods of myocardial resynchronization in GLS change within 3 months of follow up. According to these results we could suggest that both resynchronization methods could be equally used as cardiac resynchronization therapy according to GLS measurement.

Published
2021

9. Benchmarking Belgian CRT practice against the rest of Europe: insights from the ESC-CRT survey II.

Author

UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, UCL - (MGD) Service de cardiologie, Gauthey, Anaïs, Willems, Rik, Vandekerckhove, Yves, Mullens, Wilfried, Stefan, Liliana, Carryn, Xavier, Blommaert, Dominique, Mairesse, Georges, Dickstein, Kenneth, Normand, Camilla, Linde, Cecilia, Le Polain De Waroux, Jean-Benoît, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, UCL - (MGD) Service de cardiologie, Gauthey, Anaïs, Willems, Rik, Vandekerckhove, Yves, Mullens, Wilfried, Stefan, Liliana, Carryn, Xavier, Blommaert, Dominique, Mairesse, Georges, Dickstein, Kenneth, Normand, Camilla, Linde, Cecilia, and Le Polain De Waroux, Jean-Benoît

Abstract

This subanalysis of the Euro-CRT survey II specifically focus on Belgian practice for CRT implantation. It explores Belgian adherence with the guidelines but also benchmark CRT practice in Belgium against the other European countries. Overall, Belgian management of CRT implantation is performed with great agreement with guidelines. This report could be used to provide guidance for both practical and economical approaches.

Published
2020

10. Patient-specific electromechanical models of the heart for the prediction of pacing acute effects in CRT: A preliminary clinical validation

Author

Sermesant, M., Chabiniok, R., Chinchapatnam, P., Mansi, T., Billet, F., Moireau, P., Peyrat, J.M., Wong, K., Relan, J., Rhode, K., Ginks, M., Lambiase, P., Delingette, H., Sorine, M., Rinaldi, C.A., Chapelle, D., Razavi, R., and Ayache, N.

Subjects
*CARDIAC pacing, *MATHEMATICAL models, *CONGESTIVE heart failure treatment, *LEFT heart ventricle, *ELECTROPHYSIOLOGY, *CARDIAC imaging
Abstract

Abstract: Cardiac resynchronisation therapy (CRT) is an effective treatment for patients with congestive heart failure and a wide QRS complex. However, up to 30% of patients are non-responders to therapy in terms of exercise capacity or left ventricular reverse remodelling. A number of controversies still remain surrounding patient selection, targeted lead implantation and optimisation of this important treatment. The development of biophysical models to predict the response to CRT represents a potential strategy to address these issues. In this article, we present how the personalisation of an electromechanical model of the myocardium can predict the acute haemodynamic changes associated with CRT. In order to introduce such an approach as a clinical application, we needed to design models that can be individualised from images and electrophysiological mapping of the left ventricle. In this paper the personalisation of the anatomy, the electrophysiology, the kinematics and the mechanics are described. The acute effects of pacing on pressure development were predicted with the in silico model for several pacing conditions on two patients, achieving good agreement with invasive haemodynamic measurements: the mean error on dP/dt max is 47.5±35mmHgs−1, less than 5% error. These promising results demonstrate the potential of physiological models personalised from images and electrophysiology signals to improve patient selection and plan CRT. [Copyright &y& Elsevier]

Published
2012
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11. FDG PET as a predictor of response to resynchronisation therapy in patients with ischaemic cardiomyopathy.

Author

van Campen, C. M. C., Visser, Frans C., van der Weerdt, Arno P., Knaapen, Paul, Comans, Emile F. I., Lammertsma, Adriaan A., de Cock, Carel C., and Visser, Cees A.

Subjects
*CARDIOGRAPHIC tomography, *CARDIOMYOPATHIES, *DOPPLER echocardiography, *HEART failure, *ECHOCARDIOGRAPHY, *MEDICAL equipment
Abstract

Although resynchronisation therapy (CRT) is a promising addition to heart failure therapy, a substantial number of patients do not respond to CRT. As FDG PET has routinely been used for prediction of improvement after revascularisation in ischaemic cardiomyopathy, it was hypothesised that there is also a relationship between the extent of viable tissue and improvement as a result of CRT. Thirty-nine patients with ischaemic cardiomyopathy (ejection fraction 27 ± 9%) and a wide QRS complex underwent temporary pacing to determine the optimal pacing combination, i.e. that with the highest increase in cardiac index (CI) compared with baseline (measured by Doppler echocardiography). All patients also underwent FDG PET imaging. In 19 patients, CI measurements were repeated 10–12 weeks after permanent biventricular pacemaker implantation. Echocardiography (13-segment model) showed a mean of 9.8 ± 1.6 dyssynergic segments, with preserved FDG uptake in 4.1 ± 2.4 segments. CI improvement at the optimal pacing site was 20 ± 9%. There was a linear relationship between the extent of viable tissue and CI improvement during pacing ( p < 0.001). Using a cut-off value of more than three viable segments (ROC analysis), FDG PET had a sensitivity of 72% and a specificity of 71% for detection of the presence of haemodynamic improvement (i.e. a CI improvement >15%). The relation between CI improvement and viable tissue was similar at follow-up. A correlation was found between the extent of viable tissue and the haemodynamic response to CRT in patients with ischaemic cardiomyopathy, suggesting that FDG PET imaging may be useful to discriminate between responders and non-responders to CRT. [ABSTRACT FROM AUTHOR]

Published
2007
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12. Pacing with capture verification in candidates for resynchronisation therapy: A feasibility study.

Author

Biffi, Mauro, Boriani, Giuseppe, Bertini, Matteo, Silvestri, Paolo, Martignani, Cristian, and Branzi, Angelo

Abstract

Background Devices for cardiac resynchronisation therapy (CRT) deliver energy into 3 output channels. Such a burden can significantly reduce device longevity. Autocapture™ has been shown to improve pacemaker longevity and safety of right ventricular pacing in clinical studies. The aim of this study was to investigate the application of Autocapture™ during biventricular pacing (BIV) to decrease the energy cost of CRT. Methods During implantation of BIV devices, an acute study was performed to test the hypothesis that the evoked response (ER) elicited by each delivered stimulus is correctly detected and measured either on the right ventricular (RV) channel during BIV pacing with the left ventricular (LV) channel pacing first, or in the LV channel with the RV channel pacing first. A reliable measurement of ER is the critical requirement for the correct performance of Autocapture™. Results ER amplitude in the right ventricle during BIV pacing was not significantly decreased compared with RV pacing in the VVI mode (16.36 ± 5.27 mV vs 17.09 ± 6.12 mV). ER amplitude in the left ventricle during BIV pacing was not significantly decreased compared with LV pacing in the VVI mode (12.4 ± 8.95 mV vs 12.25 ± 8.97 mV). Three patients in atrial fibrillation had a DDDR pacemaker with the LV lead connected to the atrial port, and received BIV pacing with Autocapture™ turned on in the RV channel. Autocapture™ performance in the long term, as assessed by the trend of RV threshold over 20 ± 8 months, showed that LV depolarisation was never sensed as an ER on the RV channel. Conclusions Our observations support the feasibility and safety of capture verification during BIV pacing on the ventricular channel paced secondly, which could increase the longevity of CRT devices, and decrease the costs of this new therapy for heart failure patients. [ABSTRACT FROM PUBLISHER]

Published
2005
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13. Assessment of right ventricular oxidative metabolism by PET in patients with idiopathic dilated cardiomyopathy undergoing cardiac resynchronisation therapy.

Author

Knuuti, Juhani, Sundell, Jan, Naum, Alexandru, Engblom, Erik, Koistinen, Juhani, Ylitalo, Antti, Stolen, Kira Q., Kalliokoski, Riikka, Nekolla, Stephan G., Bax, K. E. Jeroen J., and Airaksinen, K. E.

Subjects
*POSITRON emission tomography, *HEART metabolism, *RIGHT heart ventricle, *CARDIOMYOPATHIES, *HEART failure, *CARDIAC imaging, *MEDICAL imaging systems, *PROGNOSIS, *CARDIOLOGY
Abstract

Purpose: Right ventricular (RV) performance is known to have prognostic value in patients with congestive heart failure (CHF). Cardiac resynchronisation therapy (CRT) has been found to enhance left ventricular (LV) energetics and metabolic reserve in patients with heart failure. The interplay between the LV and RV may play an important role in CRT response. The purpose of the study was to investigate RV oxidative metabolism, metabolic reserve and the effects of CRT in patients with CHF and left bundle brach block. In addition, the role of the RV in the response to CRT was evaluated. Methods: Ten patients with idiopathic dilated cardiomyopathy who had undergone implantation of a biventricular pacemaker 8±5 months earlier were studied under two conditions: CRT ON and after CRT had been switched OFF for 24 h. Oxidative metabolism was measured using [11C]acetate positron emission tomography (Kmono). The measurements were performed at rest and during dobutamine-induced stress (5 μg/kg per minute). LV performance and interventricular mechanical delay (interventricular asynchrony) were measured using echocardiography. Results: CRT had no effect on RV Kmono at rest (ON: 0.052±0.014, OFF: 0.047±0.018, NS). Dobutamine-induced stress increased RV Kmono significantly under both conditions but oxidative metabolism was more enhanced when CRT was ON (0.076±0.026 vs 0.065±0.027, p=0.003). CRT shortened interventricular delay significantly (45±33 vs 19±35 ms, p=0.05). In five patients the response to CRT was striking (32% increase in mean LV stroke volume, range 18-36%), while in the other five patients no response was observed (mean change +2%, range -6% to +4%). RV Kmono and LV stroke volume response to CRT correlated inversely (r=-0.66, p=0.034). None of the other measured parameters, including all LV parameters and electromechanical parameters, were associated with the response to CRT. In responders, RV Kmono with CRT OFF was significantly lower than in non-responders (0.036±0.01 vs 0.058± 0.02, p=0.047). Conclusion: CRT appears to enhance RV oxidative metabolism and metabolic reserve during stress. Patients responding to CRT appear to have lower RV oxidative metabolism at rest, suggesting that the RV plays a significant role in the response to CRT. [ABSTRACT FROM AUTHOR]

Published
2004
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14. Limited thoracotomy as a second choice alternative to transvenous implant for cardiac resynchronisation therapy delivery.

Author

Puglisi, Andrea, Lunati, Maurizio, Marullo, Antonino G.M, Bianchi, Stefano, Feccia, Mariano, Sgreccia, Fabrizio, Vicini, Ilaria, Valsecchi, Sergio, Musumeci, Francesco, and Vitali, Ettore

Abstract

Aims Left ventricular (LV) pacing via transvenous implantation has an overall success rate ranging from 88% to 92%. The aim of this study was to assess whether LV pacing via limited thoracotomy would be feasible and safe when used on a routine basis for those cases in which standard transvenous procedures proved to be ineffective or unsatisfactory. [ABSTRACT FROM PUBLISHER]

Published
2004
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15. Exploring the Electrophysiologic and Hemodynamic Effects of Cardiac Resynchronization Therapy

Subjects
STIMULATION, Cardiac resynchronization therapy, RESYNCHRONISATION THERAPY, VENTRICULAR LEAD PLACEMENT, SCAR TISSUE, Hemodynamics, Animal research, Left bundle branch block, Electrophysiology, PRESSURE-VOLUME LOOPS, DYSSYNCHRONOUS CANINE HEARTS, FAILURE, FAILING HEART, OPTIMIZATION, BUNDLE-BRANCH BLOCK
Abstract

Cardiac resynchronization therapy (CRT) is an important therapy for heart failure patients with prolonged QRS duration. In patients with left bundle branch block the altered left ventricular electrical activation results in dyssynchronous, inefficient contraction of the left ventricle. CRT aims to reverse these changes and to improve cardiac function. This article explores the electrophysiologic and hemodynamic changes that occur during CRT in patient and animal studies. It also addresses how novel techniques, such as multipoint and endocardial pacing, can further improve the electromechanical response.

Published
2017
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16. Exploring the Electrophysiologic and Hemodynamic Effects of Cardiac Resynchronization Therapy: From Bench to Bedside and Vice Versa

Author

Schreurs, Rick, Schreurs, Rick, Wiegerinck, Rob F., Prinzen, Frits W., Schreurs, Rick, Schreurs, Rick, Wiegerinck, Rob F., and Prinzen, Frits W.

Abstract

Cardiac resynchronization therapy (CRT) is an important therapy for heart failure patients with prolonged QRS duration. In patients with left bundle branch block the altered left ventricular electrical activation results in dyssynchronous, inefficient contraction of the left ventricle. CRT aims to reverse these changes and to improve cardiac function. This article explores the electrophysiologic and hemodynamic changes that occur during CRT in patient and animal studies. It also addresses how novel techniques, such as multipoint and endocardial pacing, can further improve the electromechanical response.

Published
2017

17. Resynchronisation therapy in patients with heart failure: Our results

Author

Dragutin Savic, Sinisa U. Pavlovic, Vera Jelic, Vladimir Kanjuh, Milan Petrovic, Mirjana Zivkovic, Goran Milasinovic, and Zarko Calovic

Subjects
Male, Cardiac function curve, Pacemaker, Artificial, medicine.medical_specialty, Prolonged QRS interval, heart failure, lcsh:Medicine, Electrocardiography, Ventricular Dysfunction, Left, QRS complex, Internal medicine, medicine, Humans, In patient, Coronary sinus, Ejection fraction, resynchronisation therapy, business.industry, lcsh:R, General Medicine, Middle Aged, medicine.disease, prolonged QRS interval, medicine.anatomical_structure, Ventricle, Heart failure, Cardiology, Female, business
Abstract

INTRODUCTION. Resynchronisation therapy with biventricular permanent pacing stimulation is one method of treating patients with systolic heart failure, with echocardiograph signs of ventricular asynchrony and a prolonged QRS of longer than 120 milliseconds. This method has been accepted in most medical centers around the world and was instigated in our Pacemaker Centre in December 2001, 3 months after FDA approval for human use. OBJECTIVE. The aim of the study was to present this new procedure and the results obtained from our own group of patients. METHOD. A multi-site, biventricular pacemaker, with a special electrode for left-half heart stimulation was implanted in the coronary sinus of 17 patients who had suffered systolic heart failure (12 male and 5 female, average age 59.9 years). For all of them, the duration of the QRS interval was longer than 120 ms, with left bundle branch morphology, and an ejection fraction below 30%. All the patients were NYHA class II or III. Prior to and after the implantation, a 12-channel ECG and ECHO were carried out, a b-minute hall walk test was performed, additionally, the total walked distance on a flat surface was measured, the general condition of the patient was evaluated, the number of medications being taken was noted, as was the number of days of hospitalization. RESULTS. The average time from diagnosis to implantation was 22 months, and the average post-operative follow-up was 14 months. Two of the patients died 10 and 7 months after the implantation, due to a new myocardial infarction and refractory heart failure. In addition, one patient did not show any improvement after the implantation of the multi-site pacemaker (there were three "non-responder" patients). All the other patients felt much better: decreased NYHA class for I - II class, increased left ventricle ejection fraction, reduced use of diuretics, increased b-minute hall walk distance and general walk distance on a flat surface, and decreased number of days of hospitalization. CONCLUSION. Resynchronisation heart failure therapy in the majority of patients with systolic left ventricular dysfunction and a prolonged QRS interval considerably improves cardiac function, in addition to reducing symptoms and hospital stays.

Published
2005
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20. Patient-Specific Electromechanical Models of the Heart for Prediction of the Acute Effects of Pacing in CRT: a First Validation

Author

Sermesant, Maxime, Chabiniok, Radomir, Chinchapatnam, Phani, Mansi, Tommaso, Billet, Florence, Moireau, Philippe, Peyrat, Jean-Marc, Wong, Ken C.L., Relan, Jatin, Rhode, Kawal, Ginks, Matt, Lambiase, Pier, Delingette, Hervé, Sorine, Michel, Rinaldi, C. Aldo, Chapelle, Dominique, Razavi, Reza, Ayache, Nicholas, Analysis and Simulation of Biomedical Images (ASCLEPIOS), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Modeling, analysis and control in computational structural dynamics (MACS), Inria Paris-Rocquencourt, Division of Imaging Sciences, King‘s College London, Modelling, Simulation, Control and Optimization of Non-Smooth Dynamical Systems (BIPOP), Inria Grenoble - Rhône-Alpes, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire Jean Kuntzmann (LJK), Centre National de la Recherche Scientifique (CNRS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Université Joseph Fourier - Grenoble 1 (UJF)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Centre National de la Recherche Scientifique (CNRS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Université Joseph Fourier - Grenoble 1 (UJF)-Université Pierre Mendès France - Grenoble 2 (UPMF), The Heart Hospital [London], University College of London [London] (UCL), SIgnals and SYstems in PHysiology & Engineering (SISYPHE), Department of cardiology [Guy's and St. Thomas ' hospitals] [London], Guy's and St Thomas' Hospital [London]-Guy's Hospital [London], NIHR Biomedical Research Centre [London], Guy's and St Thomas' NHS Foundation Trust-King‘s College London, and Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)

Subjects
Cardiac modelling, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, cardiovascular system, Parameter estimation, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Resynchronisation therapy, Medical imaging, [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Biophysical models
Abstract

International audience; Cardiac resynchronisation therapy (CRT) is an effective treatment for patients with congestive heart failure and a wide QRS complex. However, up to 30% of patients are non-responders to therapy in terms of exercise capacity or left ventricular reverse remodelling. A number of controversies still remain surrounding patient selection, targeted lead implantation and optimisation of this important treatment. The development of biophysical models to predict the response to CRT represents a potential strategy to address these issues. In this article, we present how the personalisation of an electromechanicalmodel of the myocardium can predict the acute haemodynamic changes associated with CRT. In order to introduce such an approach as a clinical application, we needed to design models that can be individualised from images and electrophysiological mapping of the left ventricle. In this paper the personalisation of the anatomy, the electrophysiology, the kinematics and the mechanics are described. The acuteeffects of pacing on pressure development were predicted with the in silicomodel for several pacing conditions on two patients, achieving good agreement with invasive haemodynamic measurements: the mean error on dP/dtmax is 47.5 ± 35 mm Hg s−1, less than 5% error. These promising results demonstrate the potential of physiological models personalised from images and electrophysiology signals to improve patient selection and plan CRT.

Published
2012
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21. Noninvasive imaging of cardiac venous anatomy with 64-slice multi-slice computed tomography and noninvasive assessment of left ventricular dyssynchrony by 3-dimensional tissue synchronization imaging in patients with heart failure scheduled for cardiac resynchronization therapy

Author

Van De Veire, Nico, Ajmone Marsan, Nina, Schuijf, Joanne, and Cardio-vascular diseases

Subjects
RESYNCHRONISATION THERAPY, PREDICTS RESPONSE, LEAD POSITION
Abstract

Objectives of this study were to perform a prospective head-to-head comparison between multi-slice computed tomography (MSCT) venography and invasive venography in cardiac resynchronization therapy (CRT) candidates as well as to evaluate the relation between left ventricular (LV) lead position and effect on LV dyssynchrony and immediate response to CRT. Twenty-one consecutive heart failure patients scheduled for CRT implantation were prospectively enrolled to undergo 64-slice MSCT to visualize the venous system, invasive venography during device implantation, and tri-plane tissue synchronization imaging (TSI) before and after implantation. Excellent agreement between MSCT and invasive venography was noted. No significant differences were observed between both techniques regarding vessel diameters. In 12 patients, a match was observed between the area of latest mechanical activation (on TSI) and LV lead position. These patients showed a significant decrease in LV dyssynchrony (43 +/- 7 ms to 11 +/- 9 ms, p

Published
2011

22. Echocardiographic examination in patients with corrected transposition of great arteries (L-TGA, ccTGA) with failure of systemic (anatomically) right ventricle treated with resynchronisation therapy

Author

Maziarz, Andrzej, Ząbek, Andrzej, Małecka, Barbara, and Lelakowski, Jacek

Subjects
corrected transposition of great arteries, resynchronisation therapy, echocardiography
Abstract

A congestive heart failure is common in population of adult patients with congenital heart disease, especially among patients with systemic right ventricle. According to literature 4–9% of patients with systemic right ventricle can be treated with resynchronisation therapy (CRT). Authors present results of echocardiographic examination in two patients with ccTGA treated by CRT because of failure of systemic right ventricle.

Published
2010

23. Noninvasive imaging of cardiac venous anatomy with 64-slice multi-slice computed tomography and noninvasive assessment of left ventricular dyssynchrony by 3-dimensional tissue synchronization imaging in patients with heart failure scheduled for cardiac resynchronization therapy

Author

Van De Veire, Nico, Ajmone Marsan, Nina, Schuijf, Joanne, Bleeker, Gabe B., Holman, Eduard, De Sutter, Johan, and Cardio-vascular diseases

Subjects
RESYNCHRONISATION THERAPY, PREDICTS RESPONSE, LEAD POSITION, system
Abstract

Objectives of this study were to perform a prospective head-to-head comparison between multi-slice computed tomography (MSCT) venography and invasive venography in cardiac resynchronization therapy (CRT) candidates as well as to evaluate the relation between left ventricular (LV) lead position and effect on LV dyssynchrony and immediate response to CRT. Twenty-one consecutive heart failure patients scheduled for CRT implantation were prospectively enrolled to undergo 64-slice MSCT to visualize the venous system, invasive venography during device implantation, and tri-plane tissue synchronization imaging (TSI) before and after implantation. Excellent agreement between MSCT and invasive venography was noted. No significant differences were observed between both techniques regarding vessel diameters. In 12 patients, a match was observed between the area of latest mechanical activation (on TSI) and LV lead position. These patients showed a significant decrease in LV dyssynchrony (43 +/- 7 ms to 11 +/- 9 ms, p

Published
2008

24. Pacing with capture verification in candidates for resynchronisation therapy: A feasibility study

Author

P. Silvestri, Cristian Martignani, Mauro Biffi, Matteo Bertini, Giuseppe Boriani, Angelo Branzi, Biffi M, Boriani G, Bertini M, Silvestri P, Martignani C, and Branzi A.

Subjects
medicine.medical_specialty, Pacemaker, Artificial, Left, Ventricular Function, Left, NO, Electrocardiography, Physiology (medical), Internal medicine, Atrial Fibrillation, Ventricular Function, Medicine, Humans, cardiovascular diseases, Electrodes, Pacemaker longevity, Evoked Potentials, Heart Failure, RESYNCHRONISATION THERAPY, business.industry, Cardiac Pacing, Artificial, Atrial fibrillation, Ventricular pacing, medicine.disease, EVOKED RESPONSE, Electrodes, Implanted, Pacemaker, Right, medicine.anatomical_structure, Ventricle, HEART FAILURE, Heart failure, Artificial, Cardiology, Energy cost, Ventricular Function, Right, Feasibility Studies, AUTOCAPTURE, Cardiac Pacing, Implanted, Cardiology and Cardiovascular Medicine, business, Algorithms
Abstract

Background Devices for cardiac resynchronisation therapy (CRT) deliver energy into 3 output channels. Such a burden can significantly reduce device longevity. Autocapture™ has been shown to improve pacemaker longevity and safety of right ventricular pacing in clinical studies. The aim of this study was to investigate the application of Autocapture™ during biventricular pacing (BIV) to decrease the energy cost of CRT. Methods During implantation of BIV devices, an acute study was performed to test the hypothesis that the evoked response (ER) elicited by each delivered stimulus is correctly detected and measured either on the right ventricular (RV) channel during BIV pacing with the left ventricular (LV) channel pacing first, or in the LV channel with the RV channel pacing first. A reliable measurement of ER is the critical requirement for the correct performance of Autocapture™. Results ER amplitude in the right ventricle during BIV pacing was not significantly decreased compared with RV pacing in the VVI mode (16.36 ± 5.27 mV vs 17.09 ± 6.12 mV). ER amplitude in the left ventricle during BIV pacing was not significantly decreased compared with LV pacing in the VVI mode (12.4 ± 8.95 mV vs 12.25 ± 8.97 mV). Three patients in atrial fibrillation had a DDDR pacemaker with the LV lead connected to the atrial port, and received BIV pacing with Autocapture™ turned on in the RV channel. Autocapture™ performance in the long term, as assessed by the trend of RV threshold over 20 ± 8 months, showed that LV depolarisation was never sensed as an ER on the RV channel. Conclusions Our observations support the feasibility and safety of capture verification during BIV pacing on the ventricular channel paced secondly, which could increase the longevity of CRT devices, and decrease the costs of this new therapy for heart failure patients.

Published
2005

25. Pharmacologic therapy with flecainide for asymptomatic Wolff-Parkinson-White syndrome in an infant with severe left ventricular dyssynchrony.

Author

Suzuki S, Hokosaki T, and Iwamoto M

Subjects
Echocardiography, Electrocardiography, Ambulatory, Heart Ventricles physiopathology, Humans, Infant, Male, Anti-Arrhythmia Agents therapeutic use, Flecainide therapeutic use, Ventricular Dysfunction, Left complications, Wolff-Parkinson-White Syndrome diagnostic imaging, Wolff-Parkinson-White Syndrome drug therapy
Abstract

Some asymptomatic patients with Wolff-Parkinson-White syndrome have severe left ventricular dyssynchrony and dysfunction. We describe a patient who was given a diagnosis of Wolff-Parkinson-White syndrome in infancy and had a complete response to pharmacologic therapy with flecainide. Our findings suggest that flecainide is a suitable resynchronisation therapy for such infants.

Published
2018
Full Text
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26. Chest x rays illustrating successful resynchronisation therapy

Author

Piercarlo Ballo, Francesco Guerrini, Sergio Mondillo, Roberto Favilli, and Valerio Zacà

Subjects
Cardiomyopathy, Dilated, Male, Thorax, Pacemaker, Artificial, medicine.medical_specialty, chest x ray, Miscellanea, New york heart association, Internal medicine, Idiopathic dilated cardiomyopathy, pulmonary congestive signs, medicine, Humans, Heart Failure, resynchronisation therapy, Medical treatment, business.industry, Cardiac Pacing, Artificial, Middle Aged, medicine.disease, humanities, Surgery, Radiography, Heart failure, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

A 52 year old man with idiopathic dilated cardiomyopathy and a longstanding history of heart failure refractory to optimal medical treatment (New York Heart Association (NYHA) functional class III-IV) was referred to our cardiology department for implantation of an …

Published
2005
Full Text
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27. Odstranění stimulačních hrotů ze signálu elektrokardiografu

Author

Postránecká, Tereza, Plešinger,, Filip, Smíšek, Radovan, Postránecká, Tereza, Plešinger,, Filip, and Smíšek, Radovan

Abstract

Cílem této práce je detekce stimulačních hrotů v záznamu ultra vysokofrekvenčního EKG za účelem následného odstranění stimulačních hrotů a umožnění vyhodnocení vyšších frekvenčních složek komplexu QRS. Toto vyhodnocení je nemožné při přítomnosti stimulačních hrotů. Zvolený problém je vyřešen pomocí heuristického algoritmu, který využívá proložení signálu přímkou v oblasti, která není ovlivněna stimulačním impulzem. Následně dochází k prodloužení této přímky a pomocí rozdílů mezi přímkou a signálem, případně pomocí dalších pravidel, jsou detekovány okraje stimulačního hrotu. Samotný vrchol hrotu je detekován prahováním obálky první diference originálního signálu. V práci jsou testovány i další algoritmy. Je zde též navrženo několik metod odstranění stimulačního hrotu. Práce zmiňuje i tvorbu obálek vysokofrekvenčních složek, na základě jejichž analýzy jsou porovnány navržené metody odstranění stimulačních hrotů a dále je také vyhodnocena úspěšnost detekce., The goal of this thesis is to detect pacing pulses in ultra high-frequency ECG so as to remove these pacing pulses. It makes evaluation of higher frequency components of QRS complex possible. This evaluation is impossible while pacing pulses are present. Chosen issue is solved using heuristic algorithm. Algorithm uses spacing of signal by line in the area which is not influenced by pacing pulses. Subsequently this line is made longer and using differences between line and signal (or another rules) edges of pacing pulses are detected. The top of the stimulation tip is detected by thresholding envelope of original signal´s first difference. More algorithms are tested in this thesis. Several methods of removing pacing pulses are suggested in thesis. Envelopes of high-frequency components are created. Envelopes are analyzed subsequently and suggested methods of removing pacing pulses are compared on the basis of these analysis. Finally the detection efficiency is evaluated.

28. Odstranění stimulačních hrotů ze signálu elektrokardiografu

Author

Postránecká, Tereza, Plešinger,, Filip, Smíšek, Radovan, Postránecká, Tereza, Plešinger,, Filip, and Smíšek, Radovan

Abstract

Cílem této práce je detekce stimulačních hrotů v záznamu ultra vysokofrekvenčního EKG za účelem následného odstranění stimulačních hrotů a umožnění vyhodnocení vyšších frekvenčních složek komplexu QRS. Toto vyhodnocení je nemožné při přítomnosti stimulačních hrotů. Zvolený problém je vyřešen pomocí heuristického algoritmu, který využívá proložení signálu přímkou v oblasti, která není ovlivněna stimulačním impulzem. Následně dochází k prodloužení této přímky a pomocí rozdílů mezi přímkou a signálem, případně pomocí dalších pravidel, jsou detekovány okraje stimulačního hrotu. Samotný vrchol hrotu je detekován prahováním obálky první diference originálního signálu. V práci jsou testovány i další algoritmy. Je zde též navrženo několik metod odstranění stimulačního hrotu. Práce zmiňuje i tvorbu obálek vysokofrekvenčních složek, na základě jejichž analýzy jsou porovnány navržené metody odstranění stimulačních hrotů a dále je také vyhodnocena úspěšnost detekce., The goal of this thesis is to detect pacing pulses in ultra high-frequency ECG so as to remove these pacing pulses. It makes evaluation of higher frequency components of QRS complex possible. This evaluation is impossible while pacing pulses are present. Chosen issue is solved using heuristic algorithm. Algorithm uses spacing of signal by line in the area which is not influenced by pacing pulses. Subsequently this line is made longer and using differences between line and signal (or another rules) edges of pacing pulses are detected. The top of the stimulation tip is detected by thresholding envelope of original signal´s first difference. More algorithms are tested in this thesis. Several methods of removing pacing pulses are suggested in thesis. Envelopes of high-frequency components are created. Envelopes are analyzed subsequently and suggested methods of removing pacing pulses are compared on the basis of these analysis. Finally the detection efficiency is evaluated.

29. Odstranění stimulačních hrotů ze signálu elektrokardiografu

Author

Postránecká, Tereza, Plešinger,, Filip, Smíšek, Radovan, Postránecká, Tereza, Plešinger,, Filip, and Smíšek, Radovan

Abstract

Cílem této práce je detekce stimulačních hrotů v záznamu ultra vysokofrekvenčního EKG za účelem následného odstranění stimulačních hrotů a umožnění vyhodnocení vyšších frekvenčních složek komplexu QRS. Toto vyhodnocení je nemožné při přítomnosti stimulačních hrotů. Zvolený problém je vyřešen pomocí heuristického algoritmu, který využívá proložení signálu přímkou v oblasti, která není ovlivněna stimulačním impulzem. Následně dochází k prodloužení této přímky a pomocí rozdílů mezi přímkou a signálem, případně pomocí dalších pravidel, jsou detekovány okraje stimulačního hrotu. Samotný vrchol hrotu je detekován prahováním obálky první diference originálního signálu. V práci jsou testovány i další algoritmy. Je zde též navrženo několik metod odstranění stimulačního hrotu. Práce zmiňuje i tvorbu obálek vysokofrekvenčních složek, na základě jejichž analýzy jsou porovnány navržené metody odstranění stimulačních hrotů a dále je také vyhodnocena úspěšnost detekce., The goal of this thesis is to detect pacing pulses in ultra high-frequency ECG so as to remove these pacing pulses. It makes evaluation of higher frequency components of QRS complex possible. This evaluation is impossible while pacing pulses are present. Chosen issue is solved using heuristic algorithm. Algorithm uses spacing of signal by line in the area which is not influenced by pacing pulses. Subsequently this line is made longer and using differences between line and signal (or another rules) edges of pacing pulses are detected. The top of the stimulation tip is detected by thresholding envelope of original signal´s first difference. More algorithms are tested in this thesis. Several methods of removing pacing pulses are suggested in thesis. Envelopes of high-frequency components are created. Envelopes are analyzed subsequently and suggested methods of removing pacing pulses are compared on the basis of these analysis. Finally the detection efficiency is evaluated.

30. Odstranění stimulačních hrotů ze signálu elektrokardiografu

Author

Postránecká, Tereza, Plešinger,, Filip, Postránecká, Tereza, and Plešinger,, Filip

Abstract

Cílem této práce je detekce stimulačních hrotů v záznamu ultra vysokofrekvenčního EKG za účelem následného odstranění stimulačních hrotů a umožnění vyhodnocení vyšších frekvenčních složek komplexu QRS. Toto vyhodnocení je nemožné při přítomnosti stimulačních hrotů. Zvolený problém je vyřešen pomocí heuristického algoritmu, který využívá proložení signálu přímkou v oblasti, která není ovlivněna stimulačním impulzem. Následně dochází k prodloužení této přímky a pomocí rozdílů mezi přímkou a signálem, případně pomocí dalších pravidel, jsou detekovány okraje stimulačního hrotu. Samotný vrchol hrotu je detekován prahováním obálky první diference originálního signálu. V práci jsou testovány i další algoritmy. Je zde též navrženo několik metod odstranění stimulačního hrotu. Práce zmiňuje i tvorbu obálek vysokofrekvenčních složek, na základě jejichž analýzy jsou porovnány navržené metody odstranění stimulačních hrotů a dále je také vyhodnocena úspěšnost detekce., The goal of this thesis is to detect pacing pulses in ultra high-frequency ECG so as to remove these pacing pulses. It makes evaluation of higher frequency components of QRS complex possible. This evaluation is impossible while pacing pulses are present. Chosen issue is solved using heuristic algorithm. Algorithm uses spacing of signal by line in the area which is not influenced by pacing pulses. Subsequently this line is made longer and using differences between line and signal (or another rules) edges of pacing pulses are detected. The top of the stimulation tip is detected by thresholding envelope of original signal´s first difference. More algorithms are tested in this thesis. Several methods of removing pacing pulses are suggested in thesis. Envelopes of high-frequency components are created. Envelopes are analyzed subsequently and suggested methods of removing pacing pulses are compared on the basis of these analysis. Finally the detection efficiency is evaluated.

31. Odstranění stimulačních hrotů ze signálu elektrokardiografu

Author

Postránecká, Tereza, Plešinger,, Filip, Postránecká, Tereza, and Plešinger,, Filip

Abstract

Cílem této práce je detekce stimulačních hrotů v záznamu ultra vysokofrekvenčního EKG za účelem následného odstranění stimulačních hrotů a umožnění vyhodnocení vyšších frekvenčních složek komplexu QRS. Toto vyhodnocení je nemožné při přítomnosti stimulačních hrotů. Zvolený problém je vyřešen pomocí heuristického algoritmu, který využívá proložení signálu přímkou v oblasti, která není ovlivněna stimulačním impulzem. Následně dochází k prodloužení této přímky a pomocí rozdílů mezi přímkou a signálem, případně pomocí dalších pravidel, jsou detekovány okraje stimulačního hrotu. Samotný vrchol hrotu je detekován prahováním obálky první diference originálního signálu. V práci jsou testovány i další algoritmy. Je zde též navrženo několik metod odstranění stimulačního hrotu. Práce zmiňuje i tvorbu obálek vysokofrekvenčních složek, na základě jejichž analýzy jsou porovnány navržené metody odstranění stimulačních hrotů a dále je také vyhodnocena úspěšnost detekce., The goal of this thesis is to detect pacing pulses in ultra high-frequency ECG so as to remove these pacing pulses. It makes evaluation of higher frequency components of QRS complex possible. This evaluation is impossible while pacing pulses are present. Chosen issue is solved using heuristic algorithm. Algorithm uses spacing of signal by line in the area which is not influenced by pacing pulses. Subsequently this line is made longer and using differences between line and signal (or another rules) edges of pacing pulses are detected. The top of the stimulation tip is detected by thresholding envelope of original signal´s first difference. More algorithms are tested in this thesis. Several methods of removing pacing pulses are suggested in thesis. Envelopes of high-frequency components are created. Envelopes are analyzed subsequently and suggested methods of removing pacing pulses are compared on the basis of these analysis. Finally the detection efficiency is evaluated.

32. Odstranění stimulačních hrotů ze signálu elektrokardiografu

Author

Postránecká, Tereza, Plešinger,, Filip, Postránecká, Tereza, and Plešinger,, Filip

Abstract

Cílem této práce je detekce stimulačních hrotů v záznamu ultra vysokofrekvenčního EKG za účelem následného odstranění stimulačních hrotů a umožnění vyhodnocení vyšších frekvenčních složek komplexu QRS. Toto vyhodnocení je nemožné při přítomnosti stimulačních hrotů. Zvolený problém je vyřešen pomocí heuristického algoritmu, který využívá proložení signálu přímkou v oblasti, která není ovlivněna stimulačním impulzem. Následně dochází k prodloužení této přímky a pomocí rozdílů mezi přímkou a signálem, případně pomocí dalších pravidel, jsou detekovány okraje stimulačního hrotu. Samotný vrchol hrotu je detekován prahováním obálky první diference originálního signálu. V práci jsou testovány i další algoritmy. Je zde též navrženo několik metod odstranění stimulačního hrotu. Práce zmiňuje i tvorbu obálek vysokofrekvenčních složek, na základě jejichž analýzy jsou porovnány navržené metody odstranění stimulačních hrotů a dále je také vyhodnocena úspěšnost detekce., The goal of this thesis is to detect pacing pulses in ultra high-frequency ECG so as to remove these pacing pulses. It makes evaluation of higher frequency components of QRS complex possible. This evaluation is impossible while pacing pulses are present. Chosen issue is solved using heuristic algorithm. Algorithm uses spacing of signal by line in the area which is not influenced by pacing pulses. Subsequently this line is made longer and using differences between line and signal (or another rules) edges of pacing pulses are detected. The top of the stimulation tip is detected by thresholding envelope of original signal´s first difference. More algorithms are tested in this thesis. Several methods of removing pacing pulses are suggested in thesis. Envelopes of high-frequency components are created. Envelopes are analyzed subsequently and suggested methods of removing pacing pulses are compared on the basis of these analysis. Finally the detection efficiency is evaluated.

33. Odstranění stimulačních hrotů ze signálu elektrokardiografu

Author

Postránecká, Tereza, Plešinger,, Filip, Postránecká, Tereza, and Plešinger,, Filip

Abstract

Cílem této práce je detekce stimulačních hrotů v záznamu ultra vysokofrekvenčního EKG za účelem následného odstranění stimulačních hrotů a umožnění vyhodnocení vyšších frekvenčních složek komplexu QRS. Toto vyhodnocení je nemožné při přítomnosti stimulačních hrotů. Zvolený problém je vyřešen pomocí heuristického algoritmu, který využívá proložení signálu přímkou v oblasti, která není ovlivněna stimulačním impulzem. Následně dochází k prodloužení této přímky a pomocí rozdílů mezi přímkou a signálem, případně pomocí dalších pravidel, jsou detekovány okraje stimulačního hrotu. Samotný vrchol hrotu je detekován prahováním obálky první diference originálního signálu. V práci jsou testovány i další algoritmy. Je zde též navrženo několik metod odstranění stimulačního hrotu. Práce zmiňuje i tvorbu obálek vysokofrekvenčních složek, na základě jejichž analýzy jsou porovnány navržené metody odstranění stimulačních hrotů a dále je také vyhodnocena úspěšnost detekce., The goal of this thesis is to detect pacing pulses in ultra high-frequency ECG so as to remove these pacing pulses. It makes evaluation of higher frequency components of QRS complex possible. This evaluation is impossible while pacing pulses are present. Chosen issue is solved using heuristic algorithm. Algorithm uses spacing of signal by line in the area which is not influenced by pacing pulses. Subsequently this line is made longer and using differences between line and signal (or another rules) edges of pacing pulses are detected. The top of the stimulation tip is detected by thresholding envelope of original signal´s first difference. More algorithms are tested in this thesis. Several methods of removing pacing pulses are suggested in thesis. Envelopes of high-frequency components are created. Envelopes are analyzed subsequently and suggested methods of removing pacing pulses are compared on the basis of these analysis. Finally the detection efficiency is evaluated.

34. Odstranění stimulačních hrotů ze signálu elektrokardiografu

Author

Postránecká, Tereza, Plešinger,, Filip, Smíšek, Radovan, Postránecká, Tereza, Plešinger,, Filip, and Smíšek, Radovan

Abstract

Cílem této práce je detekce stimulačních hrotů v záznamu ultra vysokofrekvenčního EKG za účelem následného odstranění stimulačních hrotů a umožnění vyhodnocení vyšších frekvenčních složek komplexu QRS. Toto vyhodnocení je nemožné při přítomnosti stimulačních hrotů. Zvolený problém je vyřešen pomocí heuristického algoritmu, který využívá proložení signálu přímkou v oblasti, která není ovlivněna stimulačním impulzem. Následně dochází k prodloužení této přímky a pomocí rozdílů mezi přímkou a signálem, případně pomocí dalších pravidel, jsou detekovány okraje stimulačního hrotu. Samotný vrchol hrotu je detekován prahováním obálky první diference originálního signálu. V práci jsou testovány i další algoritmy. Je zde též navrženo několik metod odstranění stimulačního hrotu. Práce zmiňuje i tvorbu obálek vysokofrekvenčních složek, na základě jejichž analýzy jsou porovnány navržené metody odstranění stimulačních hrotů a dále je také vyhodnocena úspěšnost detekce., The goal of this thesis is to detect pacing pulses in ultra high-frequency ECG so as to remove these pacing pulses. It makes evaluation of higher frequency components of QRS complex possible. This evaluation is impossible while pacing pulses are present. Chosen issue is solved using heuristic algorithm. Algorithm uses spacing of signal by line in the area which is not influenced by pacing pulses. Subsequently this line is made longer and using differences between line and signal (or another rules) edges of pacing pulses are detected. The top of the stimulation tip is detected by thresholding envelope of original signal´s first difference. More algorithms are tested in this thesis. Several methods of removing pacing pulses are suggested in thesis. Envelopes of high-frequency components are created. Envelopes are analyzed subsequently and suggested methods of removing pacing pulses are compared on the basis of these analysis. Finally the detection efficiency is evaluated.

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