Langenfeld H, Krein A, Kirstein M, Binner L
University Hospital of Internal Medicine, Wuärzburg, Germany.
Pacing Clin Electrophysiol. 1998 Nov;21(11 Pt 2):2187-91. doi: 10.1111/j.1540-8159.1998.tb01150.x.
The peak endocardial acceleration (PEA, unit g) shows a near correlation with myocardial contractility during the isometric systolic contraction of the heart (dP/dtmax), with sympathetic activity and, thus, with physiological heart rate modulation. The (Biomechanical Endocardial Sorin Transducer (BEST) sensor is incorporated in the tip of a pacing lead and measures PEA directly near the myocardium. In an international study, the lead was implanted with the dual chamber pacemaker Living-1 (Sorin) in 105 patients. The behavior of the PEA signal was tested under conditions of physical and mental stress and during daily life activities by 24-hour recordings of PEA (PEA Holter) at 1 to 2 months and approximately 1 year after implantation. Implantation of the BEST lead was performed without complications in all patients. The sensor functioned properly in the short- and long-term in 98% of patients. Although PEA values differed from patient to patient, the values closely reflected the variations in sympathetic activity due to physical and mental stress in each patient. During exercise and during daily life activities a close correlation between PEA and heart rate was observed among patients with normal sinus rhythm. Peak endocardial acceleration allows a nearly physiological control of the pacing rate.
在心室内压最大上升速率（dP/dtmax）的等容收缩期，心内膜峰值加速度（PEA，单位为g）与心肌收缩力密切相关，且与交感神经活动相关，进而与生理性心率调节相关。生物力学心内膜索林传感器（BEST）集成在起搏电极尖端，可直接在心肌附近测量PEA。在一项国际研究中，105例患者使用双腔起搏器Living-1（索林公司）植入该电极。在植入后1至2个月以及大约1年后，通过24小时记录PEA（PEA动态心电图），在身体和精神应激条件下以及日常生活活动中测试PEA信号的表现。所有患者植入BEST电极均无并发症。98%的患者传感器在短期和长期内功能正常。尽管不同患者的PEA值有所不同，但这些值密切反映了每位患者因身体和精神应激引起的交感神经活动变化。在窦性心律正常的患者中，运动和日常生活活动期间观察到PEA与心率密切相关。心内膜峰值加速度可实现对起搏频率近乎生理性的控制。
