Detection of atrial activation by intraventricular electrogram morphology analysis: a study to determine the feasibility of p wave synchronous pacing from a standard ventricular lead.
The detection of atrial activation from a standard ventricular pacing lead with standard ventricular electrodes would provide patients with VVI and VVIB pacing systems atrial rate response and atrial synchrony. In addition to potentially increasing cardiac output appropriately in these patients at r...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 16; no. 6; pp. 1293 - 1304 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Jun1993
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106087987&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106087987 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jun1993 vid: 16 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106087987 2009416355 10.1111/j.1540-8159.1993.tb01716.x NLM7686659 106087987 ppf: 1293 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Detection of atrial activation by intraventricular electrogram morphology analysis: a study to determine the feasibility of p wave synchronous pacing from a standard ventricular lead. aug: au: Greenhut SE Svinarich JT Randall NJ Heald SC Nappholz TA sug: subj: Atrioventricular Node Physiology Cardiac Pacing, Artificial Methods Heart Conduction System Physiology Pacemaker, Artificial Signal Processing, Computer Assisted Electrocardiography Methods Electrodes, Implanted Electrophysiology Female Male Middle Age Pilot Studies Sensitivity and Specificity Human Middle Aged: 45-64 years Female Male ab: The detection of atrial activation from a standard ventricular pacing lead with standard ventricular electrodes would provide patients with VVI and VVIB pacing systems atrial rate response and atrial synchrony. In addition to potentially increasing cardiac output appropriately in these patients at rest and during moderate exercise, P wave sensing with such a device could help reduce pacemaker syndrome. In this study, unipolar signals from distal and proximal introventricular electrodes were recorded from the right ventricular apex in 20 patients. Unipolar electrograms from 16 patients were recorded using temporary electrophysiology catheters and in four patients using permanent pacemaker leads. Approximately 3 minutes of data per patient were acquired and analyzed. After selection of a P wave template, the difference in baseline normalized area between the template and signal was calculated on a point- by-point basis. The percent of atrial depolarizations correctly detected was determined for each patient and lead configuration at the optimal threshold. Far-field P wave accuracy was better at the proximal electrode (74 ± 25%) than at the distal electrode (57 ± 34%) (P < 0.025). At the proximal electrode, 15/ 20 (75%) patients had > 70% accuracy and 11/20 (55%) patients had > 80% accuracy. At the distal electrode 10/21 (48%) patients had > 70% accuracy and 7/21 (33%) patients had > 80% accuracy, in conclusion, far-field detection of atrial activation at the ventricular proximal electrode appears possible with sufficient accuracy to provide periods of atrial rate response and synchrony in patients with a single standard lead. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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