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Biomedical subjects

Sophie Henry

Publications and source records attributed to Sophie Henry.

2 recordsLinked to original sources
PubMed2002

Holter recordings with continuous marker annotation to evaluate pacemaker function.

BACKGROUND: Pacemaker marker annotations facilitate the interpretation of device behavior in addition to ECG recordings. However, they are only available in conjunction with a programmer. We studied the diagnostic value of a prototype Telemetry Holter Decoder (THD), providing continuous marker annotations on a conventional Holter. METHODS: The study included 20 patients with VDD or DDDR pacemakers. A 24-hour Holter was performed using the THD. Marker annotations are transmitted from the pacemaker to the THD, which transforms them into analog signals, which are recorded on one of the Holter channels. RESULTS: During a total recording time of 458 hours, high quality marker annotations were retrieved for every patient. Artefacts disturbed the recordings during 184 min (0.67%). The THD provided information not discernible on the ECG: intermittent atrial undersensing during sinus rhythm (1096 times). Atrial tachycardias, not visible on the ECG, were detected in 2 patients. The activation of tachycardia response algorithms was clearly annotated in 11,516 events. A total of 8875 PVC's occurred, 57.8% of which were classified incorrectly in the event counters as conducted or fusion beats. Atrial far-field sensing or VA conduction was demonstrated 4294 times. Electromagnetic interferences, not visible on the ECG, could be seen three times. CONCLUSION: Recording of continuous high-quality marker annotation on a conventional Holter is feasible. The THD provides important information on device behavior, even in patients assumed to have regular device function, and shows to be clearly superior to ECG interpretation alone. Such data can be used for improved programming, troubleshooting and for the validation of new algorithms.

Aged↗
PubMed2002

Implementation of MADIT and MUSTT in clinical practice: results of an international survey.

BACKGROUND: The long-awaited dramatically positive outcome of the Multicenter Automatic Defibrillator Implantation Trial (MADIT II), just published by Moss et al.,(14) has generated cardiologists' interest on the implementation into clinical practice of that trial. Important lessons may be learned by examining the clinical implementation of two preceding randomized, prospective, prophylactic ICD trials: the original MADIT trial, published late 1996, and the Multicenter Unsustained Tachycardia Trial (MUSTT), published late 1999. Both demonstrated that implantable cardioverter defibrillators reduce all-cause mortality by over 50% in high risk patients without previous sustained arrhythmias. METHODS: In early 2000, we surveyed 133 active electrophysiology centers (47 American, 81 European, 5 Canadian) to determine the extent to which these practices have been implemented in clinical practice during 1999, and the responses were compared to a similar survey for the year 1998. RESULTS: ICDs implanted for MADIT or MUSTT criteria accounted for 18% of new ICD implants in 1999, 65% greater than in 1998, increasing from 6% to 11% in Europe, and from 15% to 24% in America. During 1999, 53% of patients receiving ICDs for these indications were inpatients identified during hospitalization, 27% were outpatients referred specifically for MADIT/MUSTT indications, and 20% were identified by routine screening. Per the survey, in 1999 68% of responders were "somewhat (10-20%)" and 14% were "considerably (>20%)" more likely to implant ICDs for all indications. CONCLUSIONS: Extrapolating the results of this survey to all initial ICD implants for 1999, we estimate that 8500 implants for MADIT/MUSTT criteria took place in 1999, with the overall number of such implants substantially increased over the previous year, irrespective of geographic location, and influenced significantly by the publication of MUSTT. However, screening and implant practices between centers continue to vary over a broad spectrum. It will be interesting to observe whether similar patterns will follow with MADIT II.

Clinical Trials as Topic↗