PMID- 15683525
OWN - NLM
STAT- MEDLINE
DCOM- 20050603
LR  - 20071115
IS  - 0147-8389 (Print)
IS  - 0147-8389 (Linking)
VI  - 28 Suppl 1
DP  - 2005 Jan
TI  - Serial changes in right ventricular apical pacing lead impedance predict changes 
      in left ventricular ejection fraction and functional class in heart failure 
      patients.
PG  - S50-3
AB  - Pacing impedance has been proposed to monitor the clinical status of patients 
      with congestive heart failure (CHF). This study examined whether changes in right 
      ventricular (RV) pacing impedance correlate with changes in left ventricular 
      ejection fraction (LVEF) and New York Heart Association (NYHA) functional class 
      during long-term follow-up in pacemaker recipients with CHF. The study included 
      67 patients, 70 +/- 12 years of age, in NYHA class II or III, and with a mean 
      LVEF = 29 +/- 8% at implant. LVEF, NYHA class, and bipolar pacing impedance at 
      the RV outflow tract (RVOT) and apex (RVA) were measured at implant and at 3, 6, 
      9, and 12 months of follow-up. At implant, impedance was similar in RVOT (548 +/- 
      115 Omega) and RVA (571 +/- 174 Omega). Between implant and 3 months, mean 
      impedance decreased (P < 0.0001) at both the RVOT (472 +/- 62 Omega) and RVA (488 
      +/- 86 Omega), LVEF increased (43 +/- 14%, P < 0.0001), and the NYHA class 
      decreased from 2.4 +/- 0.5 to 2.1 +/- 0.6 (P = 0.0001). Changes in RVA impedance 
      correlated with changes in LVEF (r = 0.45, P = 0.002). A 50 Omega decrease in RVA 
      impedance corresponded to a 3% decrease in LVEF. RVA impedance decreased 
      significantly as NYHA class increased from I to IV (P = 0.04). There was no 
      correlation between impedance measured at the RVOT and LVEF or NYHA class. A 
      decrease in bipolar pacing impedance at the RVA was associated with worsening 
      LVEF and the NYHA class. The use of pacing impedance to monitor the clinical 
      status in CHF is dependent on the RV pacing site.
FAU - Stambler, Bruce S
AU  - Stambler BS
AD  - University Hospitals of Cleveland, Case Western Reserve University, Cleveland, 
      Ohio 44106, USA.
FAU - Ellenbogen, Kenneth A
AU  - Ellenbogen KA
FAU - Liu, Zhe
AU  - Liu Z
FAU - Levine, Paul
AU  - Levine P
FAU - Porter, Thomas R
AU  - Porter TR
FAU - Zhang, Xiaozheng
AU  - Zhang X
CN  - ROVA Trial Investigators
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*methods
MH  - Electric Impedance
MH  - Female
MH  - Heart Failure/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Predictive Value of Tests
MH  - *Stroke Volume
EDAT- 2005/02/03 09:00
MHDA- 2005/06/04 09:00
CRDT- 2005/02/03 09:00
PHST- 2005/02/03 09:00 [pubmed]
PHST- 2005/06/04 09:00 [medline]
PHST- 2005/02/03 09:00 [entrez]
AID - PACE028 [pii]
AID - 10.1111/j.1540-8159.2005.00028.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2005 Jan;28 Suppl 1:S50-3. doi: 
      10.1111/j.1540-8159.2005.00028.x.