{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T08:07:48Z","timestamp":1791014868593,"version":"4.1.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>A completely extracardiac pacing system provides the potential for clinical advantages over existing device alternatives that require intravascular, endocardial, or epicardial contact. Preliminary studies evaluating the feasibility of cardiac pacing with a lead in the anterior mediastinum, outside the pericardium and circulatory system have been completed. These studies examined (1) the anatomic access route, (2) the usability of a delivery tool to facilitate lead placement, and (3) the pacing performance of the extracardiac lead.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Feasibility evaluations included (1) a retrospective computed tomography analysis to characterize anatomic variations related to lead access, (2) accessing the anterior mediastinum in cadavers and human subjects using a custom delivery tool, and (3) acute clinical pacing performance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Major findings: (1) A total of 166 (95%) out of 174 patients had a viable lead access path through the fourth, fifth, or sixth intercostal space. (2) Access to the targeted implant location using a delivery tool was successful in all 5 cadavers and 3 humans without use of fluoroscopy and with an average lead delivery time of 121\u00b152 s. No damage to the lung, pericardium, heart, or internal thoracic vessels occurred. (3) Pacing performance was tested in 6 human subjects showing a threshold voltage of 4.7 V (2.7\u20136.7), threshold pulse width of 1.8 ms (1.0\u20132.5), and an impedance of 1205 \u2126 (894\u20131786). R-wave amplitudes measured 9.6 mV (5.6\u201312.0).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Results support the feasibility for this completely extracardiac pacing method in a heterogeneous patient population, using a minimally invasive, parasternal, delivery approach and with adequate sensing and thresholds suited for temporary pacing.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.119.007182","type":"journal-article","created":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T09:00:19Z","timestamp":1562144419000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Feasibility of an Entirely Extracardiac, Minimally Invasive,Temporary Pacing System"],"prefix":"10.1161","volume":"12","author":[{"given":"Anne-Floor B.E.","family":"Quast","sequence":"first","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, the Netherlands (A.-F.B.E.Q., N.E.G.B., J.T.V., R.E.K., M.C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niek E.G.","family":"Beurskens","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, the Netherlands (A.-F.B.E.Q., N.E.G.B., J.T.V., R.E.K., M.C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Ebner","sequence":"additional","affiliation":[{"name":"Sanatorio Italiano, Asunci\u00f3n Paraguay (A.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Wasley","sequence":"additional","affiliation":[{"name":"Saddleback Memorial Medical Center, Laguna Hills (R.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim T.","family":"Vehmeijer","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, the Netherlands (A.-F.B.E.Q., N.E.G.B., J.T.V., R.E.K., M.C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Marcovecchio","sequence":"additional","affiliation":[{"name":"AtaCor Medical, Inc, San Clemente, CA (A.M., R.S., M.C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Sanghera","sequence":"additional","affiliation":[{"name":"AtaCor Medical, Inc, San Clemente, CA (A.M., R.S., M.C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinoud E.","family":"Knops","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, the Netherlands (A.-F.B.E.Q., N.E.G.B., J.T.V., R.E.K., M.C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin C.","family":"Burke","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, the Netherlands (A.-F.B.E.Q., N.E.G.B., J.T.V., R.E.K., M.C.B.)."},{"name":"AtaCor Medical, Inc, San Clemente, CA (A.M., R.S., M.C.B.)."},{"name":"CorVita Science Foundation, Chicago, IL (M.C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.12.014"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507192"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511643"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.15420\/aer.2017:16:1"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13140"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(82)90505-7"},{"key":"e_1_3_2_8_2","first-page":"40","article-title":"A review of temporary cardiac pacing wires.","volume":"7","author":"McCann P","year":"2007","unstructured":"McCann, P. A review of temporary cardiac pacing wires. Indian Pacing Electrophysiol J. 2007;7:40\u201349.","journal-title":"Indian Pacing Electrophysiol J"},{"key":"e_1_3_2_9_2","first-page":"1045","article-title":"[Temporary pacemakers: current use and complications].","volume":"57","author":"L\u00f3pez Ayerbe J","year":"2004","unstructured":"L\u00f3pez Ayerbe, J, Villuendas Sabat\u00e9, R, Garc\u00eda Garc\u00eda, C, Rodr\u00edguez Leor, O, G\u00f3mez P\u00e9rez, M, Cur\u00f3s Abadal, A, Serra Flores, J, Larrousse, E, Valle, V. [Temporary pacemakers: current use and complications]. Rev Esp Cardiol. 2004;57:1045\u20131052.","journal-title":"Rev Esp Cardiol"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028352"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut206"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.07.057"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.114.002076"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13263"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.118.006307"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.11.030"}],"updated-by":[{"DOI":"10.1161\/hae.0000000000000042","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T00:00:00Z","timestamp":1566259200000}}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.119.007182","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:02:20Z","timestamp":1715558540000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.119.007182"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1161\/CIRCEP.119.007182"],"URL":"https:\/\/doi.org\/10.1161\/circep.119.007182","relation":{"correction":[{"id-type":"doi","id":"10.1161\/HAE.0000000000000042","asserted-by":"object"}]},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]},"assertion":[{"value":"2019-01-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e007182"}}