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Related Experiment Videos

Detecting incipient vasovagal syncope: intraventricular acceleration

M Brignole1, C Menozzi, G Corbucci

  • 1Section of Arrhythmology, Ospedali Riuniti, Lavagna, Italy.

Pacing and Clinical Electrophysiology : PACE
|March 1, 1997
PubMed
Summary

Peak endocardial acceleration (PEA) measures ventricular contractility. While PEA changes with syncope, its correlation with heart rate suggests heart rate may be a more practical marker for anti-syncope devices.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Physiology

Background:

  • Peak endocardial acceleration (PEA) reflects myocardial contractility and left ventricular pressure changes.
  • Implantable microaccelerometers can measure PEA via pacing leads.

Purpose of the Study:

  • To investigate PEA during tilt-induced syncope under various pharmacological challenges.
  • To assess the utility of PEA as a sensing parameter for anti-syncope devices.

Main Methods:

  • Seven patients with uncertain syncope underwent tilt testing with baseline, nitroglycerin, and isoproterenol protocols.
  • Peak endocardial acceleration (PEA) was measured using an implantable microaccelerometer.
  • Syncope induction and physiological parameters (heart rate, blood pressure) were monitored.

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Main Results:

  • Syncope occurred in 1, 3, and 4 patients during baseline, nitroglycerin, and isoproterenol phases, respectively.
  • PEA increased with upright posture but fell to baseline at syncope.
  • PEA changes correlated inversely with blood pressure and directly with heart rate.

Conclusions:

  • Tilt-induced syncope can occur at varying levels of left ventricular contractility.
  • Heart rate changes correlate well with PEA, suggesting it may be a more practical parameter for syncope devices.