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Test Pulses (test + pulse)

Distribution by Scientific Domains
Medical Sciences87%

Kinds of Test Pulses

  • subthreshold test pulse
    		•

    Selected Abstracts

    Intraoperative Comparison of a Subthreshold Test Pulse with the Standard High-Energy Shock Approach for the Measurement of Defibrillation Lead Impedance

    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 1 2006
    ANDREAS SCHUCHERT M.D.
    There are two methods to measure shocking lead impedance: delivery of high-energy shocks that require patient sedation, and the painless measurement of impedance from subthreshold test pulses. The aim of this study was to compare the two methods. Methods: The study included 131 patients implanted with a standard DR (n = 71) or VR (n = 60) ICD connected to either single-coil (n = 39) or dual-coil (n = 92) defibrillation leads. The noninvasive high-energy impedance test was done using a 17 J shock after induction of ventricular tachyarrhythmias and compared to a 0.4 ,J test pulse used by the ICD for the subthreshold measurements. Results: Defibrillation lead impedance measurements were not significantly different between patients with the same shocking vector configuration. In patients with a single-coil defibrillation lead the impedance was 62 ± 9 , with the high-energy shock and 62 ± 8 , with the subthreshold test pulses (P = 0.13). Patients with a dual-coil configuration recorded average impedances of 40 ± 5 , from both tests (P = 0.44). While there was no difference in values recorded within each lead configuration, there was a significant difference in impedance between the single-coil and the dual-coil patient groups (P = 0.001). Conclusions: There was no significant difference between shocking lead impedances measured with the high-energy shock or the subthreshold test pulses. This offers the possibility of noninvasive, low-energy serial measurements of shocking lead impedance at follow-up visits and removing the need for sedation. [source]

    Subthreshold Test Pulses Versus Low Energy Shock Delivery to Estimate High Energy Lead Impedance in Implanted Cardioverter Defibrillator Patients

    PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1p2 2003
    DIRK VOLLMANN
    VOLLMANN, D., et al.: Subthreshold Test Pulses Versus Low Energy Shock Delivery to Estimate High Energy Lead Impedance in Implanted Cardioverter Defibrillator Patients. The high energy lead impedance is valuable for detecting lead failure in ICDs, but until recently shock delivery was necessary for high energy impedance measurement. This study compared the use of subthreshold test pulses and low energy test shocks to estimate the high energy impedance. Immediately after implantation of Ventak Prizm ICDs in 29 patients, the lead impedance was measured with five subthreshold (0.4 ,J) test pulses, 5 low energy (1.1 J) shocks, and two to three high energy(16 ± 4.5 J)shocks. The mean impedances measured using high energy shocks, low energy shocks, and subthreshold pulses were42.0 ± 7.3 ,, 46.5 ± 8.1 ,, and42.4 ± 7.1 ,, respectively. The impedances measured using high and low energy shocks differed significantly(P <0.0001), while those obtained by high energy shocks and low energy pulses did not(P = 0.63). According to the Pearson correlation coefficient, the impedance measurements with subthreshold pulses and low energy shocks were both closely correlated(P < 0.0001)with impedance values determined with high energy shocks. However, while the impedance values tended to be higher when measured with low energy shocks, the concordance correlation coefficient (c) was higher for subthreshold test pulse versus high energy shock(c = 0.92)than for low versus high energy shock(c = 0.73). Furthermore, the intraindividual variability of impedance measurements was lower with subthreshold pulse measurements than with low energy shocks. Compared with low energy shocks, impedance measurement with subthreshold pulses has higher reproducibility and a higher correlation with the impedance obtained by high energy shock delivery. Safe and painless high energy impedance estimation with subthreshold pulses might, therefore, help to detect ICD lead failure during routine follow-up. (PACE 2003; 26:[Pt. II]:457,460) [source]

    Intracortical inhibition and facilitation upon awakening from different sleep stages: a transcranial magnetic stimulation study

    EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2004
    Luigi De Gennaro
    Abstract Intracortical facilitation and inhibition, as assessed by the paired-pulse transcranial magnetic stimulation technique with a subthreshold conditioning pulse followed by a suprathreshold test pulse, was studied upon awakening from REM and slow-wave sleep (SWS). Ten normal subjects were studied for four consecutive nights. Intracortical facilitation and inhibition were assessed upon awakening from SWS and REM sleep, and during a presleep baseline. Independently of sleep stage at awakening, intracortical inhibition was found at 1,3-ms interstimulus intervals and facilitation at 7,15-ms interstimulus intervals. Motor thresholds were higher in SWS awakenings, with no differences between REM awakenings and wakefulness, while motor evoked potential amplitude to unconditioned stimuli decreased upon REM awakening as compared to the other conditions. REM sleep awakenings showed a significant increase of intracortical facilitation at 10 and 15 ms, while intracortical inhibition was not affected by sleep stage at awakening. While the dissociation between motor thresholds and motor evoked potential amplitudes could be explained by the different excitability of the corticospinal system during SWS and REM sleep, the heightened cortical facilitation upon awakening from REM sleep points to a cortical motor activation during this stage. [source]

    Subthreshold Test Pulses Versus Low Energy Shock Delivery to Estimate High Energy Lead Impedance in Implanted Cardioverter Defibrillator Patients

    PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1p2 2003
    DIRK VOLLMANN
    VOLLMANN, D., et al.: Subthreshold Test Pulses Versus Low Energy Shock Delivery to Estimate High Energy Lead Impedance in Implanted Cardioverter Defibrillator Patients. The high energy lead impedance is valuable for detecting lead failure in ICDs, but until recently shock delivery was necessary for high energy impedance measurement. This study compared the use of subthreshold test pulses and low energy test shocks to estimate the high energy impedance. Immediately after implantation of Ventak Prizm ICDs in 29 patients, the lead impedance was measured with five subthreshold (0.4 ,J) test pulses, 5 low energy (1.1 J) shocks, and two to three high energy(16 ± 4.5 J)shocks. The mean impedances measured using high energy shocks, low energy shocks, and subthreshold pulses were42.0 ± 7.3 ,, 46.5 ± 8.1 ,, and42.4 ± 7.1 ,, respectively. The impedances measured using high and low energy shocks differed significantly(P <0.0001), while those obtained by high energy shocks and low energy pulses did not(P = 0.63). According to the Pearson correlation coefficient, the impedance measurements with subthreshold pulses and low energy shocks were both closely correlated(P < 0.0001)with impedance values determined with high energy shocks. However, while the impedance values tended to be higher when measured with low energy shocks, the concordance correlation coefficient (c) was higher for subthreshold test pulse versus high energy shock(c = 0.92)than for low versus high energy shock(c = 0.73). Furthermore, the intraindividual variability of impedance measurements was lower with subthreshold pulse measurements than with low energy shocks. Compared with low energy shocks, impedance measurement with subthreshold pulses has higher reproducibility and a higher correlation with the impedance obtained by high energy shock delivery. Safe and painless high energy impedance estimation with subthreshold pulses might, therefore, help to detect ICD lead failure during routine follow-up. (PACE 2003; 26:[Pt. II]:457,460) [source]

    Intraoperative Comparison of a Subthreshold Test Pulse with the Standard High-Energy Shock Approach for the Measurement of Defibrillation Lead Impedance

    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 1 2006
    ANDREAS SCHUCHERT M.D.
    There are two methods to measure shocking lead impedance: delivery of high-energy shocks that require patient sedation, and the painless measurement of impedance from subthreshold test pulses. The aim of this study was to compare the two methods. Methods: The study included 131 patients implanted with a standard DR (n = 71) or VR (n = 60) ICD connected to either single-coil (n = 39) or dual-coil (n = 92) defibrillation leads. The noninvasive high-energy impedance test was done using a 17 J shock after induction of ventricular tachyarrhythmias and compared to a 0.4 ,J test pulse used by the ICD for the subthreshold measurements. Results: Defibrillation lead impedance measurements were not significantly different between patients with the same shocking vector configuration. In patients with a single-coil defibrillation lead the impedance was 62 ± 9 , with the high-energy shock and 62 ± 8 , with the subthreshold test pulses (P = 0.13). Patients with a dual-coil configuration recorded average impedances of 40 ± 5 , from both tests (P = 0.44). While there was no difference in values recorded within each lead configuration, there was a significant difference in impedance between the single-coil and the dual-coil patient groups (P = 0.001). Conclusions: There was no significant difference between shocking lead impedances measured with the high-energy shock or the subthreshold test pulses. This offers the possibility of noninvasive, low-energy serial measurements of shocking lead impedance at follow-up visits and removing the need for sedation. [source]

    Subthreshold Test Pulses Versus Low Energy Shock Delivery to Estimate High Energy Lead Impedance in Implanted Cardioverter Defibrillator Patients

    PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1p2 2003
    DIRK VOLLMANN
    VOLLMANN, D., et al.: Subthreshold Test Pulses Versus Low Energy Shock Delivery to Estimate High Energy Lead Impedance in Implanted Cardioverter Defibrillator Patients. The high energy lead impedance is valuable for detecting lead failure in ICDs, but until recently shock delivery was necessary for high energy impedance measurement. This study compared the use of subthreshold test pulses and low energy test shocks to estimate the high energy impedance. Immediately after implantation of Ventak Prizm ICDs in 29 patients, the lead impedance was measured with five subthreshold (0.4 ,J) test pulses, 5 low energy (1.1 J) shocks, and two to three high energy(16 ± 4.5 J)shocks. The mean impedances measured using high energy shocks, low energy shocks, and subthreshold pulses were42.0 ± 7.3 ,, 46.5 ± 8.1 ,, and42.4 ± 7.1 ,, respectively. The impedances measured using high and low energy shocks differed significantly(P <0.0001), while those obtained by high energy shocks and low energy pulses did not(P = 0.63). According to the Pearson correlation coefficient, the impedance measurements with subthreshold pulses and low energy shocks were both closely correlated(P < 0.0001)with impedance values determined with high energy shocks. However, while the impedance values tended to be higher when measured with low energy shocks, the concordance correlation coefficient (c) was higher for subthreshold test pulse versus high energy shock(c = 0.92)than for low versus high energy shock(c = 0.73). Furthermore, the intraindividual variability of impedance measurements was lower with subthreshold pulse measurements than with low energy shocks. Compared with low energy shocks, impedance measurement with subthreshold pulses has higher reproducibility and a higher correlation with the impedance obtained by high energy shock delivery. Safe and painless high energy impedance estimation with subthreshold pulses might, therefore, help to detect ICD lead failure during routine follow-up. (PACE 2003; 26:[Pt. II]:457,460) [source]