Evidence mapPaperPMID 27547832Full record

ArticleJACC. Clinical electrophysiology2015

Percutaneous Epicardial Pacing using a Novel Insulated Multi-electrode Lead.

Faisal F Syed, Christopher V DeSimone, Elisa Ebrille, Prakriti Gaba, Dorothy J Ladewig, Susan B Mikell, Scott H Suddendorf, Emily J Gilles, Andrew J Danielsen, Markéta Lukášová and 8 more

Abstract read
In one paragraph

Article in JACC. Clinical electrophysiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Faisal F SyedDivision of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Christopher V DeSimoneDivision of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Elisa EbrilleDivision of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Prakriti GabaMayo Medical School, Mayo Clinic, Rochester, MN.
Dorothy J LadewigMayo Clinic Ventures, Mayo Clinic, Rochester, MN.
Susan B MikellMayo Clinic Ventures, Mayo Clinic, Rochester, MN.
Scott H SuddendorfDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
Emily J GillesMayo Clinic Ventures, Mayo Clinic, Rochester, MN.
Andrew J DanielsenMayo Clinic Ventures, Mayo Clinic, Rochester, MN.
Markéta LukášováICRC - Department of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Jiří WolfICRC - Department of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Pavel LeinveberICRC - Department of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Miroslav NovákICRC - Department of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Zdeněk StárekICRC - Department of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Tomas KaraDivision of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN; ICRC - Department of Cardiovascular Diseases, St Anne's University Hospital, Brno, Czech Republic.
Charles J BruceDivision of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Paul A FriedmanDivision of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Samuel J AsirvathamDivision of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.

Funding

CARDIOVASOLOGYT32HL007111 · MAYO CLINIC ROCHESTER · 1985 to 2025
$2.4M
NHLBI NIH HHS T32 HL007111
6 · The paper itself

Abstract

introductionEpicardial cardiac resynchronization therapy (CRT) permits unrestricted electrode positioning. However, this requires surgical placement of device leads and the risk of unwanted phrenic nerve stimulation. We hypothesized that shielded electrodes can capture myocardium without extracardiac stimulation.

methodsIn 6 dog and 5 swine experiments, we used a percutaneous approach to access the epicardial surface of the heart, and deploy novel leads housing multiple electrodes with selective insulation. Bipolar pacing thresholds at prespecified sites were tested compare electrode threshold data both facing towards and away from the epicardial surface.

resultsIn 151 paired electrode recordings (70 in 6 dogs; 81 in 5 swine), thresholds facing myocardium were lower than facing away (median [IQR] mA: dogs 0.9 [0.4-1.6] vs 4.6 [2.1 to >10], p<0.0001; swine 0.5 [0.2-1] vs 2.5 [0.5-6.8], p<0.0001). Myocardial capture was feasible without extracardiac stimulation at all tested sites, with mean ± SE threshold margin 3.6±0.7 mA at sites of high output extracardiac stimulation (p=0.004).

conclusionSelective electrode insulation confers directional pacing to a multielectrode epicardial pacing lead. This device has the potential for a novel percutaneous epicardial resynchronization therapy that permits placement at an optimal pacing site, irrespective of the anatomy of the coronary veins or phrenic nerves.

Indexed as

bioelectrical therapyBiventricular pacingcardiac resynchronization therapyepicardial mappingepicardial pacingminimally invasivemultisite pacingpericardial interventionphrenic nerve stimulationsteerable pericardial sheath

Identifiers

PMID27547832
PMCPMC4991355

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.