Muscle Noise Effects on Atrial Evoked Response Sensing: Implications on Atrial Auto-Threshold and Auto-Capture Determination.

Automatic pacing capture verification algorithms that are based on detection of local evoked response signals are susceptible to interference from myopotential noise. This is especially true in the atrium where the lower signal amplitude and signal-to-noise ratio make pacing capture verification mor...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 34; no. 4; pp. 460 - 467
Autores principales: Tse, Hung-Fat, Saha, Sunipa, Garg, Ankur, Bohn, Derek, Lee, Yim Ling, Lau, Chu-Pak
Formato: equations & formulas pictorial research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Apr2011
Acceso en línea:Ver este registro en EBSCOhost
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      place: Malden, Massachusetts
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        atl: Muscle Noise Effects on Atrial Evoked Response Sensing: Implications on Atrial Auto-Threshold and Auto-Capture Determination.
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          Tse, Hung-Fat
          Saha, Sunipa
          Garg, Ankur
          Bohn, Derek
          Lee, Yim Ling
          Lau, Chu-Pak
        affil: Cardiology Division, Department of Medicine, the University of Hong Kong, Hong Kong, China
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          Heart Atrium Physiology
          Cardiac Pacing, Artificial Adverse Effects
          Noise Adverse Effects
          Electrodes, Implanted Adverse Effects
          Equipment Failure
          Artifacts Adverse Effects
          Observational Methods
          Prospective Studies
          Movement
          Human
          Paired T-Tests
          Analysis of Variance
          Male
          Female
          Aged, 80 and Over
          Aged
          Activities of Daily Living Physiology
          Algorithms
          Funding Source
          Aged, 80 & over
          Aged: 65+ years
          Male
          Female
      ab: Automatic pacing capture verification algorithms that are based on detection of local evoked response signals are susceptible to interference from myopotential noise. This is especially true in the atrium where the lower signal amplitude and signal-to-noise ratio make pacing capture verification more challenging. The aim of this study is to evaluate the impact of myopotential noise induced by various maneuvers on the atrial evoked response (AER) signal. Data were collected from 18 patients (7 M/11 F, 77.6 ± 8.8 years), implanted with a dual chamber rate response (DDDR) pacemaker and acute and chronic right atrial leads and right ventricular leads, at three regular follow-up visits scheduled at 1, 3, and 6 months after pacemaker implantation or replacement procedures. During each study visit, manual atrial pacing threshold tests during unipolar pacing in the DDD mode were conducted with two evoked response sensing configurations (RA→ Ind and RA→ V) while patients performed six different maneuvers. Noise estimates were calculated for each maneuver. The greatest noise estimates in both sensing configurations were measured during the hand-pressing exercise (0.649 ± 0.342 mV in the RA→ Ind vector, 0.309 ± 0.223 mV in the RA→ V vector). No significant differences in overall noise estimates were observed between the follow-up visits. Of the beats that exhibited noise estimates greater than a sensing floor of 0.3 mV, up to 22% of cardiac beats had a signal-to-noise ratio less than 2 in the RA→ Ind configuration. Results indicate that myopotential noise generated by performing maneuvers has a demonstrable impact on AER sensing. Therefore, noise mitigation processes are necessary in atrial automatic pacing capture verification algorithms based on evoked response signals to identify and appropriately manage noise. (PACE 2011; 34:460-466)
      pubtype: Academic Journal
      doctype:
        equations & formulas
        pictorial
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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