Serial changes in right ventricular apical pacing lead impedance predict changes in left ventricular ejection fraction and functional class in heart failure patients

Bruce S. Stambler, Kenneth A. Ellenbogen, Zhe Liu, Paul Levine, Thomas Richard Porter, Xiaozheng Zhang

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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 Ω) and RVA (571 ± 174 Ω). Between implant and 3 months, mean impedance decreased (P < 0.0001) at both the RVOT (472 ± 62 Ω) and RVA (488 ± 86 Ω), 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 Ω 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.

Original languageEnglish (US)
Pages (from-to)S50-S53
JournalPACE - Pacing and Clinical Electrophysiology
Volume28
Issue numberSUPPL. 1
DOIs
StatePublished - Jan 1 2005

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Electric Impedance
Stroke Volume
Heart Failure
Lead

Keywords

  • Congestive heart failure
  • Impedance
  • Pacing
  • Ventricular function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Serial changes in right ventricular apical pacing lead impedance predict changes in left ventricular ejection fraction and functional class in heart failure patients. / Stambler, Bruce S.; Ellenbogen, Kenneth A.; Liu, Zhe; Levine, Paul; Porter, Thomas Richard; Zhang, Xiaozheng.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 28, No. SUPPL. 1, 01.01.2005, p. S50-S53.

Research output: Contribution to journalArticle

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abstract = "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 Ω) and RVA (571 ± 174 Ω). Between implant and 3 months, mean impedance decreased (P < 0.0001) at both the RVOT (472 ± 62 Ω) and RVA (488 ± 86 Ω), 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 Ω 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.",
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