Upgrading a single-chamber leadless pacemaker to a dual-chamber leadless pacemaker system
Notice bibliographique
Résumé
Abstract Background/Introduction The first global dual-chamber leadless pacemaker (DR-LP) study included a group of subjects with a pre-existing upgradeable ventricular single chamber leadless pacemaker (VR-LP) in whom the addition of an atrial leadless pacemaker (AR-LP) was undertaken to allow upgrading to a dual chamber leadless pacing (DR-LP) system. Purpose Summarize success rates of single to dual chamber leadless pacemaker upgrades, as well as device and i2i throughput measurements, serious adverse device effects (SADEs) and mortality in this cohort. Methods Subjects with a pre-existing VR-LP who were indicated for a dual-chamber pacemaker were included. Upgrade procedures included downloading firmware to existing VR-LP, placing AR-LP, and pairing the devices to operate in a DR-LP mode. Electrical and i2i throughput measurements were collected at implant, pre-discharge, 1-mo, 3-mo, 6-mo, and 12-mo. Upgrade success rate was defined as an AR-LP upgrade procedure that resulted in a functional DR-LP system. SADEs included all reported events that were adjudicated as serious and possibly, probably or causally related to the procedure or system. SADEs and deaths were adjudicated by an independent clinical events committee. Results Out of 36 enrolled subjects (61.1% male, 70.4 ± 13.8 yrs., 55.6% sinus node dysfunction, 38.9% AV block), 35 had an attempted implant, and 32 of these were successful (91.4%). The 3 unsuccessful upgrade attempts were related to unsuccessful placement of the AR-LP due to complications during the procedure (n = 2) or an inability to implant an AR-LP (n = 1). Figure 1 illustrates a declining early mean pacing capture threshold, rising early P-wave amplitudes, and stable impedance for the AR-LP over the 12 months. Mean i2i throughput for communication from the RV to RA and the RA to RV improved from pre-discharge to 3 months and remained stable through the subsequent 9 months (Figure 2). A total of 5 subjects (5 of 36; 13.9%) experienced 7 SADEs (all procedure-related; 2 related to the AR-LP and 2 to the delivery catheter). One non-cardiovascular, non-device, non-procedure related death occurred in the upgrade population. Conclusions The single to dual-chamber upgrade cohort demonstrated a high upgrade success rate (91.4%), stable atrial and ventricular electrical measurements and consistently high i2i communication throughout the 12 months. AV synchrony (AVS) was not specifically measured in this upgrade cohort, but data from the main DR-LP study suggest that i2i throughput correlates with, but significantly underestimates AVS. Further, the rate of complications was acceptable (13.9%) and limited to the procedure. These data confirm the feasibility, safety and longer-term effectiveness of adding an atrial LP in patients with a pre-existing ventricular LP order to achieve effective dual chamber pacing.Fig. 1: Upgrade Electrical measurementsFig. 2: i2i communication for Upgrades
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».