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...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 12; no. 10; pp. 1104 - 1109
Autores principales: Butter C, Hartung WM, Kay GN, Willems R, Zhang G, Lang DJ, Fleck E
Formato: clinical trial research Journal Article
Publicado: Wiley-Blackwell Oct2001
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2001
      vid: 12
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Clinical validation of new pacing-sensing configurations for atrial automatic capture verification in pacemakers.
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          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
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