P wave recognition and atrial stimulation with fractally iridium coated VDD single pass leads.
Pacing Clin Electrophysiol
; 17(11 Pt 2): 1883-8, 1994 Nov.
Article
en En
| MEDLINE
| ID: mdl-7845786
ABSTRACT
UNLABELLED The bottleneck of VDD systems is the reliable detection of the small atrial signals by a floating atrial electrode. Fractally iridium coated electrodes offer excellent sensing and pacing performance. In this study, the performance of such a floating atrial lead in P wave sensing and synchronous ventricular stimulation was examined. Atrial pacing was also used as a test of atrial wall contact. PATIENTS AND METHODS:
A fractally iridium coated VDD lead was implanted in 18 patients. In 15 patients it was interfaced with a VDD pacemaker and in 3 patients with a DDD system depending on the P wave amplitude measured acutely (> or = 2 mV). Simultaneous recordings of the surface ECG and pacemaker telemetry were used to analyze P wave amplitudes and AV synchrony in different body positions, and during normal and deep breathing. Additionally, exercise tests based on daily life activities and 24-hour ECG monitoring were performed to test the pacemaker function.RESULTS:
During implantation P wave amplitudes were 1.86 mV +/- 1.08 mV (range 0.5-4.9 mV) and during follow-up (6.6 +/- 5.6 weeks) 0.18-3.8 mV. Holter recordings revealed reliable P wave sensing at a sensitivity setting of 0.5 mV (95.5%). P wave sensing was further improved by a higher atrial sensitivity. AV synchronous pacing > or = 99.9% was achieved in all patients. In 7 patients the atrial electrode could be positioned close to the atrial wall enabling atrial stimulation thresholds at an average of 4.3 volts.CONCLUSION:
This fractally iridium coated VVD lead allowed consistent and reliable P wave sensing at an atrial sensitivity as low as 0.5 mV in selected patients.
Buscar en Google
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Marcapaso Artificial
/
Electrocardiografía
Límite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Año:
1994
Tipo del documento:
Article
País de afiliación:
Países Bajos