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- W2000536648 abstract "The bottleneck of VDD systems is the reliable detection of the small atrial signals by a floating atrial electrode. Fractally iridium coated electrodes offer excellent sensing and pacing performance. In this study, the performance of such a floating atrial lead in P wave sensing and synchronous ventricular stimulation was examined. Atrial pacing was also used as a test of atrial wall contact. Patients and Methods: A fractally iridium coated VDDlead was implanted in 18 patients. In 15 patients it was interfaced with a VDD pacemaker and in 3 patients with a DDD system depending on the P wave amplitude measured acutely (≥ 2 mV). Simultaneous recordings of the surface ECG and pacemaker telemetry were used to analyze P wave amplitudes and AV synchrony in different body positions, and during normal and deep breathing. Additionally, exercise tests based on daily life activities and 24-hour ECG monitoring were performed to test the pacemaker function. Results: During implantation P wave amplitudes were 1.86 mV ± 1.08 mV (range 0.5–4.9 mV) and during follow-up (6.6 ± 5.6 weeks) 0.18–3.8 mV. Holter recordings revealed reliable P wave sensing at a sensitivity setting of 0.5 mV (95.5%). P wave sensing was further improved by a higher atrial sensitivity. AV synchronous pacing ± 99.9% was achieved in all patients. In 7 patients the atrial electrode could be positioned close to the atrial wall enabling atrial stimulation thresholds at an average of 4.3 volts. Conclusion: This fractally iridium coated VVD lead allowed consistent and reliable P wave sensing at an atrial sensitivity as low as 0.5 mV in selected patients." @default.
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- W2000536648 date "1994-11-01" @default.
- W2000536648 modified "2023-09-27" @default.
- W2000536648 title "P Wave Recognition and Atrial Stimulation with Fractally Iridium Coated VDD Single Pass Leads" @default.
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- W2000536648 doi "https://doi.org/10.1111/j.1540-8159.1994.tb03768.x" @default.
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