Letters to the Editor – Brief papers about basic research or clinical experiences
Systemic bioimpedance analysis in patients with implanted cardiac stimulation devices
Análisis de bioimpedancia sistémica en pacientes portadores de dispositivos de estimulación cardiaca
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Recent studies have shown the superiority of BIVA in the estimation of fluid overload over strict clinical criteria during haemodialysis sessions.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The use of BIVA in this context helps to improve fluid control, blood pressure, quality life scores, and also predicts clinical outcome such as hospitalizations due to cardiovascular causes.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The population with cardiac stimulation devices increases every year, particularly within our patient population. The annual consumption of conventional generators and cardiac resynchronization devices with or without defibrillator is estimated to be 745.8 and 53.1 units per million inhabitants respectively. This is the most recent data obtained by the Spanish Society of Cardiology, considering that there are 35,000 implants per year in Spain.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Although it is not well known whether BIVA can affect the function of cardiac stimulation devices, most manufacturers and even clinical practice guidelines<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> advice against its use in this group of patients, due to the risk of electrical interference that may result in signal oversensing, stimulation inhibition, inappropriate defibrillator shocks or other functional anomalies. These restrictions limit the use of BIVA in many patients with a history of cardiopathy, particularly for those with cardiac failure.</p><p id="par0025" class="elsevierStylePara elsevierViewall">As a consequence, we decided to assess if BIVA caused electromagnetic interference or generator malfunction in patients with cardiac stimulation devices. To do this, all admissions to our centre due to acute decompensation of cardiac failure between January and June 2014 were prospectively studied. The analysis was performed prior to discharge, using a CardioEFGTM model at a frequency of 50<span class="elsevierStyleHsp" style=""></span>kHz. The study was authorized by the Clinical Trials and Research Committee of our centre. Out of 77 patients studied, 21 had cardiac device (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Prior to BIVA, all generators and wires showed normal function. During BIVA, it was not detected any effects on intracavitary electrocardiograms, we did not observe any inappropriate sensing in channels. No telemetric interferences were observed between the cardiac device and the programming device either. Upon repetition of the interrogation after BIVA, no changes in the wire parameters nor alterations in the functioning of the generator device were detected in any of the patients.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Literature on the safety of bioimpedance analysis of the body in patients with cardiac stimulation devices is scarce, although due to widespread use evidence of safety is needed. Recently, Buch et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> found no alterations in the generators during the use of BIVA, in a cohort of 20 outpatients with chronic cardiac failure. In this study, as in ours, there is a limited number of patients and the use of a single system of analysis. Nevertheless both studies suggest that the use of BIVA in patients with cardiac devices is safe within this context.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Fabregat-Andrés Ó, Fácila L, Montagud-Balaguer V, Galán-Serrano A. Análisis de bioimpedancia sistémica en pacientes portadores de dispositivos de estimulación cardiaca. Nefrologia. 2015;35:345–346.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Results expressed as median<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation (quantitative variables), or in numbers and percentages (qualitative variables). CRT-D: cardiac resynchronization therapy with defibrillator; LV: left ventricle; BIVA: systemic bioimpedance vector analysis.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>21) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Age (years)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">73<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Male (n, %)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 (57) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Time since first implant</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (3–12) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">LV ejection fraction (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Type of device (n, %)</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pacemaker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CRT-D \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Implant diagnosis (n, %)</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sick sinus syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (28) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Atrio-ventricular block \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (24) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sudden death primary prevention \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (28) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sudden death secondary prevention \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Device brand (n, %)</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medtonic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (33) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Biotronik \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (28) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>St. Jude Medical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Boston Scientific \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Vitatron Medical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sorin Group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Cardiac rhythm during the analysis (n, %)</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sinus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 (52) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Atrial fibrillation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (19) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bicameral stimulation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ventricular stimulation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Bioimpedance value</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BIVA (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">75.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab942098.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the study population.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bioimpedance-guided fluid management in maintenance hemodialysis: a pilot randomized controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 2 | 6 |
| 2024 October | 36 | 54 | 90 |
| 2024 September | 44 | 20 | 64 |
| 2024 August | 55 | 59 | 114 |
| 2024 July | 26 | 22 | 48 |
| 2024 June | 56 | 32 | 88 |
| 2024 May | 62 | 30 | 92 |
| 2024 April | 39 | 36 | 75 |
| 2024 March | 37 | 25 | 62 |
| 2024 February | 34 | 33 | 67 |
| 2024 January | 34 | 23 | 57 |
| 2023 December | 29 | 33 | 62 |
| 2023 November | 42 | 23 | 65 |
| 2023 October | 62 | 41 | 103 |
| 2023 September | 70 | 19 | 89 |
| 2023 August | 63 | 25 | 88 |
| 2023 July | 73 | 23 | 96 |
| 2023 June | 40 | 21 | 61 |
| 2023 May | 50 | 38 | 88 |
| 2023 April | 58 | 10 | 68 |
| 2023 March | 64 | 25 | 89 |
| 2023 February | 41 | 13 | 54 |
| 2023 January | 32 | 24 | 56 |
| 2022 December | 45 | 23 | 68 |
| 2022 November | 44 | 24 | 68 |
| 2022 October | 43 | 30 | 73 |
| 2022 September | 41 | 38 | 79 |
| 2022 August | 35 | 41 | 76 |
| 2022 July | 30 | 37 | 67 |
| 2022 June | 39 | 31 | 70 |
| 2022 May | 25 | 26 | 51 |
| 2022 April | 33 | 36 | 69 |
| 2022 March | 38 | 36 | 74 |
| 2022 February | 31 | 31 | 62 |
| 2022 January | 43 | 34 | 77 |
| 2021 December | 42 | 32 | 74 |
| 2021 November | 32 | 35 | 67 |
| 2021 October | 41 | 43 | 84 |
| 2021 September | 30 | 34 | 64 |
| 2021 August | 28 | 38 | 66 |
| 2021 July | 24 | 26 | 50 |
| 2021 June | 18 | 24 | 42 |
| 2021 May | 33 | 27 | 60 |
| 2021 April | 71 | 36 | 107 |
| 2021 March | 46 | 36 | 82 |
| 2021 February | 12 | 17 | 29 |
| 2021 January | 32 | 12 | 44 |
| 2020 December | 22 | 12 | 34 |
| 2020 November | 24 | 12 | 36 |
| 2020 October | 21 | 10 | 31 |
| 2020 September | 18 | 17 | 35 |
| 2020 August | 34 | 7 | 41 |
| 2020 July | 23 | 9 | 32 |
| 2020 June | 26 | 11 | 37 |
| 2020 May | 35 | 18 | 53 |
| 2020 April | 29 | 17 | 46 |
| 2020 March | 35 | 20 | 55 |
| 2020 February | 29 | 36 | 65 |
| 2020 January | 28 | 25 | 53 |
| 2019 December | 30 | 33 | 63 |
| 2019 November | 38 | 35 | 73 |
| 2019 October | 512 | 12 | 524 |
| 2019 September | 25 | 27 | 52 |
| 2019 August | 17 | 28 | 45 |
| 2019 July | 23 | 24 | 47 |
| 2019 June | 21 | 10 | 31 |
| 2019 May | 22 | 21 | 43 |
| 2019 April | 35 | 34 | 69 |
| 2019 March | 25 | 16 | 41 |
| 2019 February | 21 | 13 | 34 |
| 2019 January | 31 | 13 | 44 |
| 2018 December | 89 | 37 | 126 |
| 2018 November | 172 | 20 | 192 |
| 2018 October | 142 | 27 | 169 |
| 2018 September | 76 | 10 | 86 |
| 2018 August | 32 | 17 | 49 |
| 2018 July | 43 | 15 | 58 |
| 2018 June | 37 | 7 | 44 |
| 2018 May | 175 | 17 | 192 |
| 2018 April | 50 | 5 | 55 |
| 2018 March | 89 | 5 | 94 |
| 2018 February | 50 | 8 | 58 |
| 2018 January | 36 | 4 | 40 |
| 2017 December | 54 | 12 | 66 |
| 2017 November | 37 | 21 | 58 |
| 2017 October | 41 | 9 | 50 |
| 2017 September | 44 | 18 | 62 |
| 2017 August | 41 | 21 | 62 |
| 2017 July | 46 | 12 | 58 |
| 2017 June | 47 | 21 | 68 |
| 2017 May | 34 | 20 | 54 |
| 2017 April | 35 | 17 | 52 |
| 2017 March | 29 | 43 | 72 |
| 2017 February | 37 | 12 | 49 |
| 2017 January | 17 | 12 | 29 |
| 2016 December | 53 | 12 | 65 |
| 2016 November | 70 | 18 | 88 |
| 2016 October | 114 | 28 | 142 |
| 2016 September | 141 | 9 | 150 |
| 2016 August | 147 | 10 | 157 |
| 2016 July | 160 | 7 | 167 |
| 2016 June | 123 | 0 | 123 |
| 2016 May | 126 | 0 | 126 |
| 2016 April | 120 | 0 | 120 |
| 2016 March | 98 | 0 | 98 |
| 2016 February | 118 | 0 | 118 |
| 2016 January | 122 | 0 | 122 |
| 2015 December | 112 | 0 | 112 |
| 2015 November | 124 | 0 | 124 |
| 2015 October | 147 | 0 | 147 |
| 2015 September | 179 | 0 | 179 |
| 2015 August | 155 | 0 | 155 |
| 2015 July | 40 | 0 | 40 |
Show all
