Pseudo‐elevation of conduction system pacing threshold through parallel connection of an intracardiac electrogram recording system
Pseudo‐elevation of conduction system pacing threshold through parallel connection of an intracardiac electrogram recording system
复制标题
并联心内电图记录系统伪提升传导系统起搏阈值
DOI：
10.1111/jce.15129
复制
发表时间：
2021
影响因子：
2.7
通讯作者：
Komuro Issei
中科院分区：
文献类型：
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作者：
Yokota Jun;Fujiu Katsuhito;Oshima Tsukasa;Matsubara Takumi J;Matsuda Jun;Shimizu Yu;Hasumi Eriko;Kojima Toshiya;Doi Kent;Komuro Issei
电生理记录系统（EP系统）与传导系统起搏（CSP）设备的并联已广泛用于心内电图的精细监测和起搏评估。我们经历了一个病例，当电生理系统并联时，在特定条件下出现非预期的起搏阈值恶化。我们使用离体模型评估了潜在的机制。使用示波器、起搏系统分析仪（PSA）、EP系统和模拟心脏生成离体起搏和心内电描记图监测模型。在各种条件下，使用各种起搏设备组合，测量了PSA的预期输出与模拟心脏的实际测量输出值之间的差异。EP系统的并联连接与在模拟心脏处记录的来自PSA的电输出减少相关。当使用RMC-5000电生理系统时，在起搏功能开启的情况下，意外的不良反应尤为明显，只需关闭系统的起搏功能，故障就完全解决了。当PSA和EP系统并行展开时，EP系统可能会增加CSP中的起搏阈值。由于起搏阈值较高，该问题可能导致CSP假性失效。当RMC-5000用于传导系统起搏时，与起搏测试的PSA并行，应关闭RMC-5000的起搏功能。
Parallel connection of an electrophysiology recording system (EP system) to equipment for conduction system pacing (CSP) has been widely used for fine monitoring of intracardiac electrograms and pacing evaluation. We experienced a case showing unexpected pacing threshold exacerbation under specific conditions when the EP system was connected in parallel. We evaluated the underlying mechanism using an ex vivo model. An ex vivo pacing and intracardiac electrogram monitoring model was generated using an oscilloscope, pacing system analyzer (PSA), EP system, and simulated heart. The discrepancy between expected output at the PSA and the actual measured output value at the simulated heart was measured under various conditions and using various combinations of pacing equipment. Parallel connection of the EP system was associated with reduced electrical output from the PSA as recorded at the simulated heart. The unexpected adverse effects were particularly noticeable when using an RMC‐5000 EP system with the pacing function on. The trouble is completely resolved by simply turning off the pacing function of the system. There is a possibility that the EP system might increase the pacing threshold in CSP when the PSA and EP system is are deployed in parallel. The issue may provoke pseudo failure of CSP due to the high pacing threshold. When the RMC‐5000 is used for conduction system pacing in parallel with a PSA for the pacing test, the pacing function of RMC‐5000 should be turned off.