Introduction : Computerized Heart Allograft Rejection Monitoring (CHARM) used for non invasiv rejection monitoring in HTX recipients is based on the analysis of ventricular evoked response (VER) signals. The aim of this study was to evaluate the prognostic validity of the TslewC, a parameter calculated out of VER.
Methods : During oHTX two unipolar fractally coated scrwe-in leads were implanted epimyocardially, one to the left and one to the right ventricular and connected to a telemetric pacemaker. Recordings of IEGMs were performed routinely at hospital. Data processing was done, artifacts were eliminated and trend curves of the patients were displayed. TslewC was calculated from the tangent of VER and evaluated from 105 patients. The patients were deveided in survivors and non-survivors. For statistic analysis two-tailed t-test was performed.
Results: Patients in the non-survivors group compared to the controll group showed a significant lower TslewC in the final follow-up [p < 0.001]. The differences were even more impressiv in patients with a recorded IEGM 30 days prior to dead or with a cardiac death reason.
Tests were performed to find an optimal prognostic threshold of the TslewC and finally found (26mV).
Conclusion : TslewC can function as prognostic factor after oHTX. Further studies should be initialize to provide the prognostic threshold so that patients would not be forced to show up routinely all 4 weeks for follow up visits. Patients would only have to addent hospital if the TslewC is under this prognostic threshold.