Open AccessIntramyocardial electrograms for non‐invasive rejection monitoring: initial experience with an infection‐specific parameter
Author(s) -
Grasser B.,
Iberer F.,
Schreier G.,
Allmayer A.,
Schaffellner S.,
Prenner G.,
Wasler A.,
Petutschnigg B.,
Müller H.,
Tscheliessnigg KH.
Publication year - 1998
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.1998.tb01192.x
Subject(s) - medicine , predictive value , cardiology , predictive value of tests
Non‐invasive rejection monitoring based on the analysis of paced intramyocardial electrograms enables repeated or even daily graft surveillance. The rejection‐sensitive parameter is calculated from the maximum slope of the descending part of the t wave. Biopsy‐proven rejection grade 2 or higher (ISHLT classification) can safely be detected. Nevertheless, infection influences the rejection‐sensitive parameter in the same manner as does rejection (99% negative predictive value for rejection grade 2 or higher, 17 % positive predictive value). We defined the infection‐specific parameter as the time on the O line between the pacemaker stimulus and the crossover with the maximum slope of the descending part of the t wave. Patients were classified prospectively according to infection status: patients without infection and those with clinically apparent infection. Patients with clinically apparent infections had a significantly longer infection‐specific parameter. A simultaneous decrease of the rejection‐sensitive parameter and an increase in the infection‐specific parameter was observed during clinical infection; a decrease in the rejection‐sensitive parameter and no changes in the infection‐specific parameter were observed during rejection. This preliminary analysis revealed that discrimination of rejection and infection might be possible by the analysis of intramyocardial electrograms.