13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-40

Peak endocardial accelerometer in critical settings

Andrea Colella, Giuseppe Vaccari*, Enrico Dovellini*, Gian Carlo Calamai*, Gianni Plicchi**, Massimo Bonacchi*, Marino Vaccari*, Antonio Michelucci, Maria Cristina Porciani, Luigi Padeletti, Gian Franco Gensini.
Dept. of Internal Medicine and Cardiology, University of Florence, Dept. of Cardiology and Cardiac Surgery, Florence, Dept. of Engineering, University of Bologna, Italy

Introduction

Recently a new sensor based on a microaccelerometer mounted in the tip of a standard ventricular pacing lead has been developed for myocardial contractility assessment^1,2.

At present a new DDDR pacemaker is under clinical evaluation in Europe and 113 chronical implants have been made (as in April 1997).

Peak endocardial accelerometer (PEA) provides a direct measurement of the amplitude of myocardial vibrations generated during the isovolumic contraction of the heart, and associated with the first heart sound.

The good correlation between PEA and LV dP/dt max during adrenergic stimulation (r > 0.9, p < 0.001)³ and the dependence of PEA on the activity of the left ventricle⁴ offer potential for diagnostic applications in myocardial function monitoring. The intrinsic structure of the sensor, which is sealed into a hermetic and rigid capsule, makes it very suitable for chronical implants and the fibrosis surrounding the lead increases the mechanical contact between the tip and heart wall, improving the performance of the sensor.

We investigated the usefulness of PEA integrated into a pacemaker system (PMS) (BEST-Living, Sorin Biomedica, Italy) for monitoring heart function in patients in critical setting.