New Features Physiologic Data

The increased storage capability of cardiac resynchronization therapy (CRT) devices allow beat-to-beat analysis that enables continuous sampling of physiologic parameters. Device-based monitoring of heart rate and time-domain parameters of heart rate variability (HRV) can be helpful in evaluating the therapeutic effects of CRT in heart failure patients. Diminished HRV and an increased mean heart rate in patients with heart failure are associated with a poor prognosis [2].

Continuous monitoring of the thoracic impedance is used since a long time to increase pacing rate; it became available again in some devices to assess fluid overload (Figure 3.18). Detection of decreased thoracic impedance could lead to early diagnosis of volume overload [3].

Figure 3.16. Interval plot of sinus tachycardia, and the accompanying electrogram. During the initial rhythm, the interval plot shows that each ventricular activity is preceded by an atrial activity. The ventricular intervals have a cycle length of ^ 450 ms. The interval plot shows a gradual increase in ventricular rate. During the tachyarrhythmia, the atrioventricular conduction gradually increases until the arrhythmia reaches a stable cycle length of ^ 440-450 ms. During the tachyarrhythmia, each ventricular activity is preceded by an atrial activity.

Figure 3.16. Interval plot of sinus tachycardia, and the accompanying electrogram. During the initial rhythm, the interval plot shows that each ventricular activity is preceded by an atrial activity. The ventricular intervals have a cycle length of ^ 450 ms. The interval plot shows a gradual increase in ventricular rate. During the tachyarrhythmia, the atrioventricular conduction gradually increases until the arrhythmia reaches a stable cycle length of ^ 440-450 ms. During the tachyarrhythmia, each ventricular activity is preceded by an atrial activity.

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