Intramyocardial electrograms for non-invasive rejection monitoring: initial experience with an infection-specific parameter

Transplant International : Official Journal of the European Society for Organ Transplantation
Barbara GrasserK H Tscheliessnigg

Abstract

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 reje...Continue Reading

Citations

Dec 9, 2000·Transplant International : Official Journal of the European Society for Organ Transplantation·B GrasserK H Tscheliessnigg

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