14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-56

Application of non-excitatory electrical current to improve cardiac contractility: a new pacing approach in congestive heart failure

Carlo Pappone, Salvatore Rosanio, Gabriele Vicedomini, Carlo Meloni, Cosimo Dicandia, Adriano Salvati, Vincenzo Santinelli, Patrizio Mazzone, Giuseppe Oreto, Sergio Chierchia.
Division of Cardiology, Hospital S.Raffaele, Milan, Italy

Methods

We selected 15 patients with dilated CHF (idiopathic, n=7; ischemic n=8) in NYHA class III or IV. All patients were in normal synus rhythm. ES were conveyed to the LV free wall through commercially available LV pacing microcatheters positioned via the coronary sinus. In addition, patients were instrumented with a right ventricular pacing catheter, and an 8F dual micromanometer catheter placed in the LV and aorta to measure peak +dP/dt (mmHg/s) and aortic pulse pressure (PP, mmHg). Two dimensional echocardiography with color Doppler and pulsed-wave tissue Doppler imaging were recorded during the acute study. ES were synchronized to LV electrical activity through two independent sense amplifiers and delivered during the absolute refractory period. Signal delivery was automatically inhibited during sensed arrhythmic events. The SCEPTRE device has pacing capabilities and reverts to a safe VVI pacing mode upon detection of any unexpected behavior. ES application lasted a maximum of 30 min.