Intraoperative study of polarization and evoked response signals in different endocardial electrode designs.

Some new generation pacemakers use an algorithm based on evoked response (EH) detection to verify beat-to-beat capture and to enable automatic adjustment of output. This is a prospective acute study of polarization signal (PS) and ER in nine currently available electrodes. Intraoperative testing of...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 24; no. 7; pp. 1055 - 1061
Autores principales: Lau C, Nishimura SC, Yee R, Lefeuvre C, Philippon F, Cameron DA
Formato: research Journal Article
Publicado: Wiley-Blackwell Jul2001
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2001
      vid: 24
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1046/j.1460-9592.2001.01055.x
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        atl: Intraoperative study of polarization and evoked response signals in different endocardial electrode designs.
      aug:
        au:
          Lau C
          Nishimura SC
          Yee R
          Lefeuvre C
          Philippon F
          Cameron DA
      sug:
        subj:
          Pacemaker, Artificial
          Adult
          Aged
          Aged, 80 and Over
          Electrodes
          Equipment Design
          Evoked Potentials
          Female
          Male
          Middle Age
          Prospective Studies
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Some new generation pacemakers use an algorithm based on evoked response (EH) detection to verify beat-to-beat capture and to enable automatic adjustment of output. This is a prospective acute study of polarization signal (PS) and ER in nine currently available electrodes. Intraoperative testing of ventricular bipolar electrodes used the Autocapture (AC) algorithm. The intrinsic R wave, PS, ER. acceptance of AC function, and stimulation thresholds (STs) were obtained. Ventricular electrodes were categorized as follows: titanium nitride (TiN)-coated passive and active fixation, high impedance (HI), passive fixation (VP), iridium oxide-coated titanium (IROX) (VI), and platinum helix (PH) active fixation. Acute testing was performed in 217 patients with an average age of' 74.26 years. 59.6% were men with primary pacing indication-SSS (46.3%). There were no significant differences found with respect to R wave and threshold between the various electrodes. PH active-fixation electrodes had significantly higher ER and PS than other groups including the TiN-coated active-fixation electrodes. TiN-coated electrodes (active and passive fixation) bad significantly lower PS than other electrodes. As a result, TiN electrodes bad a significantly higher functional rate of AC (91.7%), whereas PH bad the lowest rate (0%). In conclusion. (1) polarization characteristics are significantly different for commercially available ventricular electrodes, (2) certain physical features at the tissue to electrode interface like TiN coating appears to be more important in determining PS than electrode tip size and fixation method, and (3) the current algorithm for AC requires electrodes that provide low polarization for satisfactory performance.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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