The Experts below are selected from a list of 10074 Experts worldwide ranked by ideXlab platform
Mario Pascual - One of the best experts on this subject based on the ideXlab platform.
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predictors of atrial mechanical sensing and atrioVentricular synchrony with a leadless Ventricular Pacemaker results from the marvel 2 study
Heart Rhythm, 2020Co-Authors: Christophe Garweg, Clemens Steinwender, Surinder Kaur Khelae, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Background The MARVEL (Micra Atrial TRacking Using a Ventricular AccELerometer) 2 study assessed the efficacy of atrioVentricular (AV) synchronous pacing with a Micra leadless Pacemaker. Average atrioVentricular synchrony (AVS) was 89.2%. Previously, low amplitude of the Micra-sensed atrial signal (A4) was observed to be a factor of low AVS. Objective The purpose of this study was to identify predictors of A4 amplitude and high AVS. Methods We analyzed 64 patients enrolled in MARVEL 2 who had visible P waves on electrocardiogram for assessing A4 amplitude and 40 patients with third-degree AV block for assessing AVS at rest. High AVS was defined as >90% correct atrial-triggered Ventricular pacing. The association between clinical factors and echocardiographic parameters with A4 amplitude was investigated using a multivariable model with lasso variable selection. Variables associated with A4 amplitude together with premature Ventricular contraction burden, sinus rate, and sinus rate variability (standard deviation of successive P-P intervals [SDSD]) were assessed for association with AVS. Results In univariate analysis, low A4 amplitude was inversely related to atrial function assessed by E/A ratio and eʹ/aʹ ratio, and was directly related to atrial contraction excursion (ACE) and atrial strain (Ɛa) on echocardiography (all P ≤.05). The multivariable lasso regression model found coronary artery bypass graft history, E/A ratio, ACE, and Ɛa were associated with low A4 amplitude. E/A ratio and SDSD were multivariable predictors of high AVS, with >90% probability if E/A Conclusion Clinical parameters and echocardiographic markers of atrial function are associated with A4 signal amplitude. High AVS can be predicted by E/A ratio
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atrioVentricular synchronous pacing using a leadless Ventricular Pacemaker results from the marvel 2 study
JACC: Clinical Electrophysiology, 2020Co-Authors: Clemens Steinwender, Surinder Kaur Khelae, Christophe Garweg, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Abstract Objectives This study reports on the performance of a leadless Ventricular Pacemaker with automated, enhanced accelerometer-based algorithms that provide atrioVentricular (AV) synchronous ...
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atrioVentricular synchronous pacing using a leadless Ventricular Pacemaker results from the marvel 2 study
JACC: Clinical Electrophysiology, 2020Co-Authors: Clemens Steinwender, Surinder Kaur Khelae, Christophe Garweg, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Abstract Objectives We report performance of a leadless Ventricular Pacemaker with automated, enhanced accelerometer-based algorithms to provide atrioVentricular (AV) synchronous pacing. Background Despite many advantages, leadless Pacemakers are currently only capable of single-chamber Ventricular pacing. Methods The prospective Micra Atrial tRacking using a Ventricular accELerometer (MARVEL) 2 study assessed the performance of an automated, enhanced accelerometer-based algorithm downloaded for up to 5 hours in patients with AV block implanted with a Micra leadless Pacemaker. The primary efficacy objective was to demonstrate the superiority of the algorithm to provide AV synchronous (VDD) pacing versus VVI-50 pacing in patients with sinus rhythm and complete AV block. The primary safety objective was to demonstrate that the algorithm did not result in pauses or heart rates >100 bpm. Results Overall, 75 patients from 12 centers were enrolled and received a software download of the accelerometer-based algorithm to their leadless Pacemakers. Among the 40 patients with sinus rhythm and complete AV block included in the primary efficacy objective analysis, the percentage of patients with ≥70% AV synchrony at rest was significantly greater with VDD pacing than with VVI pacing (95% vs. 0%, P Conclusion Accelerometer-based atrial sensing with an automated, enhanced algorithm significantly improved AV synchrony in patients with sinus rhythm and AV block implanted with a leadless Ventricular Pacemaker.
Philippe Ritter - One of the best experts on this subject based on the ideXlab platform.
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predictors of atrial mechanical sensing and atrioVentricular synchrony with a leadless Ventricular Pacemaker results from the marvel 2 study
Heart Rhythm, 2020Co-Authors: Christophe Garweg, Clemens Steinwender, Surinder Kaur Khelae, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Background The MARVEL (Micra Atrial TRacking Using a Ventricular AccELerometer) 2 study assessed the efficacy of atrioVentricular (AV) synchronous pacing with a Micra leadless Pacemaker. Average atrioVentricular synchrony (AVS) was 89.2%. Previously, low amplitude of the Micra-sensed atrial signal (A4) was observed to be a factor of low AVS. Objective The purpose of this study was to identify predictors of A4 amplitude and high AVS. Methods We analyzed 64 patients enrolled in MARVEL 2 who had visible P waves on electrocardiogram for assessing A4 amplitude and 40 patients with third-degree AV block for assessing AVS at rest. High AVS was defined as >90% correct atrial-triggered Ventricular pacing. The association between clinical factors and echocardiographic parameters with A4 amplitude was investigated using a multivariable model with lasso variable selection. Variables associated with A4 amplitude together with premature Ventricular contraction burden, sinus rate, and sinus rate variability (standard deviation of successive P-P intervals [SDSD]) were assessed for association with AVS. Results In univariate analysis, low A4 amplitude was inversely related to atrial function assessed by E/A ratio and eʹ/aʹ ratio, and was directly related to atrial contraction excursion (ACE) and atrial strain (Ɛa) on echocardiography (all P ≤.05). The multivariable lasso regression model found coronary artery bypass graft history, E/A ratio, ACE, and Ɛa were associated with low A4 amplitude. E/A ratio and SDSD were multivariable predictors of high AVS, with >90% probability if E/A Conclusion Clinical parameters and echocardiographic markers of atrial function are associated with A4 signal amplitude. High AVS can be predicted by E/A ratio
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atrioVentricular synchronous pacing using a leadless Ventricular Pacemaker results from the marvel 2 study
JACC: Clinical Electrophysiology, 2020Co-Authors: Clemens Steinwender, Surinder Kaur Khelae, Christophe Garweg, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Abstract Objectives This study reports on the performance of a leadless Ventricular Pacemaker with automated, enhanced accelerometer-based algorithms that provide atrioVentricular (AV) synchronous ...
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atrioVentricular synchronous pacing using a leadless Ventricular Pacemaker results from the marvel 2 study
JACC: Clinical Electrophysiology, 2020Co-Authors: Clemens Steinwender, Surinder Kaur Khelae, Christophe Garweg, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Abstract Objectives We report performance of a leadless Ventricular Pacemaker with automated, enhanced accelerometer-based algorithms to provide atrioVentricular (AV) synchronous pacing. Background Despite many advantages, leadless Pacemakers are currently only capable of single-chamber Ventricular pacing. Methods The prospective Micra Atrial tRacking using a Ventricular accELerometer (MARVEL) 2 study assessed the performance of an automated, enhanced accelerometer-based algorithm downloaded for up to 5 hours in patients with AV block implanted with a Micra leadless Pacemaker. The primary efficacy objective was to demonstrate the superiority of the algorithm to provide AV synchronous (VDD) pacing versus VVI-50 pacing in patients with sinus rhythm and complete AV block. The primary safety objective was to demonstrate that the algorithm did not result in pauses or heart rates >100 bpm. Results Overall, 75 patients from 12 centers were enrolled and received a software download of the accelerometer-based algorithm to their leadless Pacemakers. Among the 40 patients with sinus rhythm and complete AV block included in the primary efficacy objective analysis, the percentage of patients with ≥70% AV synchrony at rest was significantly greater with VDD pacing than with VVI pacing (95% vs. 0%, P Conclusion Accelerometer-based atrial sensing with an automated, enhanced algorithm significantly improved AV synchrony in patients with sinus rhythm and AV block implanted with a leadless Ventricular Pacemaker.
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the rationale and design of the micra transcatheter pacing study safety and efficacy of a novel miniaturized Pacemaker
Europace, 2015Co-Authors: Philippe Ritter, Gabor Z Duray, Shu Zhang, Calambur Narasimhan, Kyoko Soejima, Razali Omar, Verla Laager, Kurt Stromberg, Eric R Williams, Dwight ReynoldsAbstract:Aims Recent advances in miniaturization technologies and battery chemistries have made it possible to develop a Pacemaker small enough to implant within the heart while still aiming to provide similar battery longevity to conventional Pacemakers. The Micra Transcatheter Pacing System is a miniaturized single-chamber Pacemaker system that is delivered via catheter through the femoral vein. The Pacemaker is implanted directly inside the right ventricle of the heart, eliminating the need for a device pocket and insertion of a pacing lead, thereby potentially avoiding some of the complications associated with traditional pacing systems. Methods and results The Micra Transcatheter Pacing Study is currently undergoing evaluation in a prospective, multi-site, single-arm study. Approximately 720 patients will be implanted at up to 70 centres around the world. The study is designed to have a continuously growing body of evidence and data analyses are planned at various time points. The primary safety and efficacy objectives at 6-month post-implant are to demonstrate that (i) the percentage of Micra patients free from major complications related to the Micra system or implant procedure is significantly higher than 83% and (ii) the percentage of Micra patients with both low and stable thresholds is significantly higher than 80%. The safety performance benchmark is based on a reference dataset of 977 subjects from 6 recent Pacemaker studies. Conclusions The Micra Transcatheter Pacing Study will assess the safety and efficacy of a miniaturized, totally endocardial Pacemaker in patients with an indication for implantation of a single-chamber Ventricular Pacemaker. ClinicalTrials.gov registration ID NCT02004873.
Clemens Steinwender - One of the best experts on this subject based on the ideXlab platform.
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predictors of atrial mechanical sensing and atrioVentricular synchrony with a leadless Ventricular Pacemaker results from the marvel 2 study
Heart Rhythm, 2020Co-Authors: Christophe Garweg, Clemens Steinwender, Surinder Kaur Khelae, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Background The MARVEL (Micra Atrial TRacking Using a Ventricular AccELerometer) 2 study assessed the efficacy of atrioVentricular (AV) synchronous pacing with a Micra leadless Pacemaker. Average atrioVentricular synchrony (AVS) was 89.2%. Previously, low amplitude of the Micra-sensed atrial signal (A4) was observed to be a factor of low AVS. Objective The purpose of this study was to identify predictors of A4 amplitude and high AVS. Methods We analyzed 64 patients enrolled in MARVEL 2 who had visible P waves on electrocardiogram for assessing A4 amplitude and 40 patients with third-degree AV block for assessing AVS at rest. High AVS was defined as >90% correct atrial-triggered Ventricular pacing. The association between clinical factors and echocardiographic parameters with A4 amplitude was investigated using a multivariable model with lasso variable selection. Variables associated with A4 amplitude together with premature Ventricular contraction burden, sinus rate, and sinus rate variability (standard deviation of successive P-P intervals [SDSD]) were assessed for association with AVS. Results In univariate analysis, low A4 amplitude was inversely related to atrial function assessed by E/A ratio and eʹ/aʹ ratio, and was directly related to atrial contraction excursion (ACE) and atrial strain (Ɛa) on echocardiography (all P ≤.05). The multivariable lasso regression model found coronary artery bypass graft history, E/A ratio, ACE, and Ɛa were associated with low A4 amplitude. E/A ratio and SDSD were multivariable predictors of high AVS, with >90% probability if E/A Conclusion Clinical parameters and echocardiographic markers of atrial function are associated with A4 signal amplitude. High AVS can be predicted by E/A ratio
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atrioVentricular synchronous pacing using a leadless Ventricular Pacemaker results from the marvel 2 study
JACC: Clinical Electrophysiology, 2020Co-Authors: Clemens Steinwender, Surinder Kaur Khelae, Christophe Garweg, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Abstract Objectives This study reports on the performance of a leadless Ventricular Pacemaker with automated, enhanced accelerometer-based algorithms that provide atrioVentricular (AV) synchronous ...
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atrioVentricular synchronous pacing using a leadless Ventricular Pacemaker results from the marvel 2 study
JACC: Clinical Electrophysiology, 2020Co-Authors: Clemens Steinwender, Surinder Kaur Khelae, Christophe Garweg, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Abstract Objectives We report performance of a leadless Ventricular Pacemaker with automated, enhanced accelerometer-based algorithms to provide atrioVentricular (AV) synchronous pacing. Background Despite many advantages, leadless Pacemakers are currently only capable of single-chamber Ventricular pacing. Methods The prospective Micra Atrial tRacking using a Ventricular accELerometer (MARVEL) 2 study assessed the performance of an automated, enhanced accelerometer-based algorithm downloaded for up to 5 hours in patients with AV block implanted with a Micra leadless Pacemaker. The primary efficacy objective was to demonstrate the superiority of the algorithm to provide AV synchronous (VDD) pacing versus VVI-50 pacing in patients with sinus rhythm and complete AV block. The primary safety objective was to demonstrate that the algorithm did not result in pauses or heart rates >100 bpm. Results Overall, 75 patients from 12 centers were enrolled and received a software download of the accelerometer-based algorithm to their leadless Pacemakers. Among the 40 patients with sinus rhythm and complete AV block included in the primary efficacy objective analysis, the percentage of patients with ≥70% AV synchrony at rest was significantly greater with VDD pacing than with VVI pacing (95% vs. 0%, P Conclusion Accelerometer-based atrial sensing with an automated, enhanced algorithm significantly improved AV synchrony in patients with sinus rhythm and AV block implanted with a leadless Ventricular Pacemaker.
Christophe Garweg - One of the best experts on this subject based on the ideXlab platform.
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predictors of atrial mechanical sensing and atrioVentricular synchrony with a leadless Ventricular Pacemaker results from the marvel 2 study
Heart Rhythm, 2020Co-Authors: Christophe Garweg, Clemens Steinwender, Surinder Kaur Khelae, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Background The MARVEL (Micra Atrial TRacking Using a Ventricular AccELerometer) 2 study assessed the efficacy of atrioVentricular (AV) synchronous pacing with a Micra leadless Pacemaker. Average atrioVentricular synchrony (AVS) was 89.2%. Previously, low amplitude of the Micra-sensed atrial signal (A4) was observed to be a factor of low AVS. Objective The purpose of this study was to identify predictors of A4 amplitude and high AVS. Methods We analyzed 64 patients enrolled in MARVEL 2 who had visible P waves on electrocardiogram for assessing A4 amplitude and 40 patients with third-degree AV block for assessing AVS at rest. High AVS was defined as >90% correct atrial-triggered Ventricular pacing. The association between clinical factors and echocardiographic parameters with A4 amplitude was investigated using a multivariable model with lasso variable selection. Variables associated with A4 amplitude together with premature Ventricular contraction burden, sinus rate, and sinus rate variability (standard deviation of successive P-P intervals [SDSD]) were assessed for association with AVS. Results In univariate analysis, low A4 amplitude was inversely related to atrial function assessed by E/A ratio and eʹ/aʹ ratio, and was directly related to atrial contraction excursion (ACE) and atrial strain (Ɛa) on echocardiography (all P ≤.05). The multivariable lasso regression model found coronary artery bypass graft history, E/A ratio, ACE, and Ɛa were associated with low A4 amplitude. E/A ratio and SDSD were multivariable predictors of high AVS, with >90% probability if E/A Conclusion Clinical parameters and echocardiographic markers of atrial function are associated with A4 signal amplitude. High AVS can be predicted by E/A ratio
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atrioVentricular synchronous pacing using a leadless Ventricular Pacemaker results from the marvel 2 study
JACC: Clinical Electrophysiology, 2020Co-Authors: Clemens Steinwender, Surinder Kaur Khelae, Christophe Garweg, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Abstract Objectives This study reports on the performance of a leadless Ventricular Pacemaker with automated, enhanced accelerometer-based algorithms that provide atrioVentricular (AV) synchronous ...
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atrioVentricular synchronous pacing using a leadless Ventricular Pacemaker results from the marvel 2 study
JACC: Clinical Electrophysiology, 2020Co-Authors: Clemens Steinwender, Surinder Kaur Khelae, Christophe Garweg, Joseph Yatsun Chan, Philippe Ritter, Jens Brock Johansen, Venkata Sagi, Laurence M Epstein, Jonathan P Piccini, Mario PascualAbstract:Abstract Objectives We report performance of a leadless Ventricular Pacemaker with automated, enhanced accelerometer-based algorithms to provide atrioVentricular (AV) synchronous pacing. Background Despite many advantages, leadless Pacemakers are currently only capable of single-chamber Ventricular pacing. Methods The prospective Micra Atrial tRacking using a Ventricular accELerometer (MARVEL) 2 study assessed the performance of an automated, enhanced accelerometer-based algorithm downloaded for up to 5 hours in patients with AV block implanted with a Micra leadless Pacemaker. The primary efficacy objective was to demonstrate the superiority of the algorithm to provide AV synchronous (VDD) pacing versus VVI-50 pacing in patients with sinus rhythm and complete AV block. The primary safety objective was to demonstrate that the algorithm did not result in pauses or heart rates >100 bpm. Results Overall, 75 patients from 12 centers were enrolled and received a software download of the accelerometer-based algorithm to their leadless Pacemakers. Among the 40 patients with sinus rhythm and complete AV block included in the primary efficacy objective analysis, the percentage of patients with ≥70% AV synchrony at rest was significantly greater with VDD pacing than with VVI pacing (95% vs. 0%, P Conclusion Accelerometer-based atrial sensing with an automated, enhanced algorithm significantly improved AV synchrony in patients with sinus rhythm and AV block implanted with a leadless Ventricular Pacemaker.
M Winkuang D Shen - One of the best experts on this subject based on the ideXlab platform.
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bradycardia induced polymorphic Ventricular tachycardia after atrioVentricular junction ablation for sinus tachycardia induced cardiomyopathy
Journal of Cardiovascular Electrophysiology, 1995Co-Authors: Roland R Brandt, M Winkuang D ShenAbstract:In a patient with severe left Ventricular dysfunction resulting from chronic nonparoxysmal sinus tachycardia, rate control and improvement in left Ventricular function were achieved with atrioVentricular junction ablation and Ventricular Pacemaker implantation. Within 12 hours after the ablation procedure, several episodes of polymorphic Ventricular tachycardia that may have been triggered by the abruptly decreased heart rate occurred. Recurrence of polymorphic Ventricular tachycardia was prevented by an increase in pacing rate.
