Abstract
Sophisticated monitoring of atrial activity is a prerequisite for modern pacemaker therapy. Ideally, near-fields and ventricular far-fields ought to be distinguished by beat-to-beat template analysis of the atrial signal. A prerequisite is that atrial signals are stable under different conditions. A Matlab routine was developed to analyze atrial electrograms of 23 patients at least 3 months after implantation of a dual chamber pacemaker under several conditions including at rest, bipolar at rest, in an upright position, during treadmill exercise, and postexercise. A near-field and far-field template was created and amplitudes, widths, and slew rates were measured. In bipolar configuration, near-field amplitude at rest was 3.04 +/- 0.94 mV (unipolar)/3.36 +/- 1.0 mV (bipolar) versus 3.18 +/- 1.0 mV (bipolar) at peak exercise. Far-field amplitude at rest was 1.66 +/- 1.18 (unipolar)/0.47 +/- 0.27 mV (bipolar) and 0.41 +/- 0.21 mV (bipolar) at peak exercise (n.s. for bipolar measurements). No overall significant changes were observed for near- and far-field widths and slew rates during exercise. Shorter tip-ring distances of the atrial bipole, lead position, and the presence of sinus node disease did not have any impact on overall...Continue Reading
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