Clinical validation of new pacing-sensing configurations for atrial automatic capture verification in pacemakers.
Introduction: This study evaluated an atrial automatic capture verification scheme based on atrial evoked response (AER). Atrial pacing was between Atip and Can (Atip-Can) using different coupling capacitances (CCs). Independent pairs of sensing electrodes between Aring and Vtip (Aring-Vtip) or betw...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 12; no. 10; pp. 1104 - 1109 |
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| Autores principales: | , , , , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2001
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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=106088833&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106088833 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Oct2001 vid: 12 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106088833 106088833 2009418591 10.1046/j.1540-8167.2001.01104.x NLM11699516 106088833 ppf: 1104 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Clinical validation of new pacing-sensing configurations for atrial automatic capture verification in pacemakers. aug: au: Butter C Hartung WM Kay GN Willems R Zhang G Lang DJ Fleck E sug: subj: Cardiac Pacing, Artificial Heart Atrium Physiopathology Pacemaker, Artificial Perception Adult Aged Aged, 80 and Over Clinical Trials Electrocardiography Electrodes Evoked Potentials Physiology Female Heart Function Tests Male Middle Age Prospective Studies Human Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Introduction: This study evaluated an atrial automatic capture verification scheme based on atrial evoked response (AER). Atrial pacing was between Atip and Can (Atip-Can) using different coupling capacitances (CCs). Independent pairs of sensing electrodes between Aring and Vtip (Aring-Vtip) or between Aring and a separate indifferent electrode (Aring-Indiff) were used to reduce pacing-induced afterpotentials. Methods and Results: A custom-made external pacing system was used to perform automatic step-up and step-down pacing (0.1 to 7.1 V at 0.5 msec, step size of 0.1 V) using different CCs (2 or 15 uF). Intracardiac signals from Aring-Indiff and Aring-Vtip were independently recorded and analyzed both in real time and off-line to detect AER. Every paced beat also was visually inspected and compared with surface ECG to verify the captures. With the intracardiac signals properly filtered, AER detection was based on the signal within a window of 12 to 65 msec after the stimulus. Data from 27 patients (4 chronic and 23 acute implantations; age 65.6 ± 13.9 years) were analyzed. Bipolar atrial lead measurements using a standard pacing system analyzer were as follows (mean ± SD): impedance 695 ± 227 , P wave amplitude 4.2 ± 2.3 mV, slew rate 1.1 ± 0.9 V/sec, and pacing threshold at 0.5 msec 1.0 ± 0.5 V. The results with CC = 2 uF showed that of 9,500 atrial paced beats, correct capture verification rates were -99.8% (Aring-Indiff) and 99.4% (Aring-Vtip). Similar results were achieved with CC = 15 uF (99.7% and 99.5%, respectively). Conclusion: AER can be reliably detected using independent pacing (Atip-Can) and sensing (Aring-Vtip or Aring-Indiff) electrodes. Therefore, atrial automatic capture verification by AER detection is feasible. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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