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ICD-measured heart sounds and their correlation with echocardiographic indexes of systolic and diastolic function

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Novel implantable defibrillators (ICDs) allow first (S1) and third (S3) heart sounds to be measured by means of an embedded accelerometer. ICD-measured S1 and S3 have been shown to significantly correlate with hemodynamic changes in acute animal models. The HeartLogic algorithm (Boston Scientific) measures and combines multiple parameters, including S3 and S1, into a single index to predict impending heart failure decompensation. We evaluated the echocardiographic correlates of ICD-measured S1 and S3 in patients with ICD and cardiac resynchronization therapy ICD.

Methods

The HeartLogic feature was activated in 104 patients. During in-office visits, patients underwent echocardiographic evaluation, and parameters of systolic and diastolic function were correlated with S3 and S1 amplitude measured on the same day as the visit.

Results

S3 amplitude inversely correlated with deceleration time of the E-wave (r = −0.32; 95% CI -0.46 – -0.17; P < 0.001), and S1 amplitude significantly correlated with left ventricular ejection fraction (r = 0.17; 95% CI 0.03–0.30; P = 0.021). S3 > 0.9 mG detected a restrictive filling pattern with 85% (95% CI 72%–93%) sensitivity and 82% (95% CI 75%–88%) specificity, while S1 < 1.5 mG detected ejection fraction < 35% with 28% (95% CI 19%–40%) sensitivity and 88% (95% CI 80%–93%) specificity.

Conclusion

ICD-measured heart sound parameters are significantly correlated with echocardiographic indexes of systolic and diastolic function. This confirms their utility for remote patient monitoring when used as single sensors and their potential relevance when considered in combination with other physiological ICD sensors that evaluate various aspects of heart failure physiology.

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Author information

Authors and Affiliations

  1. Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169, Rome, Italy

    Leonardo Calò & Ermenegildo De Ruvo

  2. Università Politecnica delle Marche, Ancona, Italy

    Alessandro Capucci & Laura Cipolletta

  3. “Giovan Battista Grassi” Hospital, Rome, Ostia lido, Italy

    Luca Santini & Fabrizio Ammirati

  4. Fondazione Poliambulanza, Brescia, Italy

    Domenico Pecora & Carmelo La Greca

  5. University of Bari, Policlinico di Bari, Bari, Italy

    Stefano Favale

  6. Fondazione Policlinico S. Matteo IRCCS, Pavia, Italy

    Barbara Petracci

  7. Sacro Cuore-Don Calabria Hospital, Verona, Negrar, Italy

    Giulio Molon

  8. Unità Operativa di Elettrofisiologia, Studio e Terapia delle Aritmie, Monaldi Hospital, Naples, Italy

    Valter Bianchi & Antonio D’Onofrio

  9. Boston Scientific Italia, Milan, Italy

    Monica Campari & Sergio Valsecchi

Authors
  1. Leonardo Calò
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  2. Alessandro Capucci
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  3. Luca Santini
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Corresponding author

Correspondence to Leonardo Calò.

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Conflict of interest

M. Campari and S. Valsecchi are employees of Boston Scientific, Inc. No other conflicts of interest exist.

Ethical approval

The study was approved by the Local Ethics Committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclosures

M. Campari and S. Valsecchi are employees of Boston Scientific. The other authors report no conflicts.

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Calò, L., Capucci, A., Santini, L. et al. ICD-measured heart sounds and their correlation with echocardiographic indexes of systolic and diastolic function. J Interv Card Electrophysiol 58, 95–101 (2020). https://doi.org/10.1007/s10840-019-00668-y

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  • DOI: https://doi.org/10.1007/s10840-019-00668-y

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