Multicenter experiences with a single lead electrode for dual chamber ICD systems.

Monitoring of atrial signals improves the accuracy in identifying supra ventricular tachyarrhythmias to prevent inappropriate therapies in patients with implantable ICDs. Since difficulties due to the additional atrial lead were found in dual chamber lCD systems with two leads, the authors designed...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 24; no. 10; pp. 1489 - 1494
Autores principales: Niehaus M, Schuchert A, Thamasett S, Pfeiffer D, Korte T, Pichlmaier M, Panning B, Belke R, Tebbenjohanns J
Formato: research Journal Article
Publicado: Wiley-Blackwell Oct2001
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2001
      vid: 24
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1046/j.1460-9592.2001.01489.x
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        atl: Multicenter experiences with a single lead electrode for dual chamber ICD systems.
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        au:
          Niehaus M
          Schuchert A
          Thamasett S
          Pfeiffer D
          Korte T
          Pichlmaier M
          Panning B
          Belke R
          Tebbenjohanns J
      sug:
        subj:
          Arrhythmia Therapy
          Defibrillators, Implantable
          Aged
          Electrodes
          Equipment Design
          Female
          Male
          Human
          Aged: 65+ years
          Female
          Male
      ab: Monitoring of atrial signals improves the accuracy in identifying supra ventricular tachyarrhythmias to prevent inappropriate therapies in patients with implantable ICDs. Since difficulties due to the additional atrial lead were found in dual chamber lCD systems with two leads, the authors designed a single pass VDD lead for use with dual chamber ICDs. After a successful animal study, the prototype VDD lead (single coil defibrillation lead with two additional fractally coated rings for bipolar sensing in the atrium) was temporarily used in 30 patients during a German multicenter study. Atrial and ventricular signals were recorded during sinus rhythm (SR), atrial flutter, AF, and VT or VF. The implantation of the lead was successful in 27 of 30 patients. Mean atrial pacing threshold was 2.5 ;± 0.9 V/0.5 ms, mean atrial impedance was 213 ± 31. Atrial amplitudes were greater during SR (2.7 ± 1.6 mV) than during atrial flutter (1.46 ± 0.3 mV, P < 0.05) or AF (0.93 ± 0.37 mV, P < 0.01). During VF atrial 'sinus' signals had significantly (P <0.01) lower amplitudes (1.4 ± 0.52 mV,) than during SR. The mean ventricular sensing was 13.3 ± 7.9 rnV and mean ventricular impedance was 577 ± 64 . Defibrillation was successful with a 20-J shock in all patients. In addition, 99.6% of P waves could be detected in SR and 84.4% of flutter waves during atrial flutter. During AF, 56.6% of a trial signals could be detected without modification of the signal amplifier. In conclusion, a new designed VDD dual chamber lead provides stable detection of a trial and ventricular signals during SR and atrial flutter. Reliable detection of atrial signals is possible without modification of the ICD amplifier.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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