Wiegand, Uwe K. H. and Nowak, Bernd and Reisp, Udo and Peiffer, Torsten and Bode, Frank and Potratz, Jürgen (2002) Implantation strategy of the atrial dipole impacts atrial sensing performance of single lead VDD pacemakers. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 25 (3). pp. 316-323. ISSN 0147-8389
Full text not available from this repository. (Request a copy)Abstract
Intermittent atrial undersensing is observed in a considerable percentage of patients with single lead VDD pacemakers. Analyzing the 2-year data of the Saphir Multi-center Follow-Up Study Study, the authors investigated predictors for the occurrence of undersensing. The study included 194 patients with high degree AV block who received a VDD pacemaker system with an identical sensing amplifier. Placement strategy of the atrial dipole was left to the discretion of the implanting physician. At the final position, atrial potential amplitudes mere measured during deep and shallow respiration. Atrial dipole position was determined by intraoperative fluoroscopy subdividing the right atrium in a high, mid, and low portion. Undersensing was defined by evidence of at least one not sensed P nave during Holter monitoring or exercise testing and by the presence of 0.1-0.2 mV amplitudes in the P wave amplitude histogram of the pacemaker. Incidence of undersensing was 25.8%; 9.3% of patients showed frequent (>5%) or symptomatic undersensing. Patients with undersensing were older (76.6+/-10.6 vs 64.2+/-14.8 years), showed a lower minimum of intraoperative atrial potential amplitude (P-min 0.86+/-0.64 vs 1.43+/-0.77 mV), a wider range of potential amplitude (DeltaP 1.71+/-1.44 vs 0.94+/-0.84 mV), and a higher incidence of dipole placement in the low right atrium (50.0% vs 11.1%, P<0.001 for all comparisons). In a multivariate regression analysis, patient age > 66 years, P-min < 0.6 mV, > 1.3 mV and atrial dipol placement in the low right atrium were independently predictive for undersensing. Minimal atrial potential amplitude, range of potential amplitude, and atrial dipole position influence aerial sensing performance in single lead VDD pacing. Thus, implantation guidelines should reflect these miles to improve the outcome of VDD pacemaker recipients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | P-WAVE AMPLITUDE; AV-SYNCHRONY; MULTICENTER; HISTOGRAM; ELECTRODE; DEVICES; SYSTEM; single lead VDD pacemaker; prediction of atrial undersensing; implantation rules |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 08 Nov 2021 16:32 |
| Last Modified: | 08 Nov 2021 16:32 |
| URI: | https://pred.uni-regensburg.de/id/eprint/40558 |
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