Abstract
Floating P wave sensing can be derived from bipolar atrial electrodes with different electrode configurations, although the relative clinical efficacy of these methods of atrial sensing has not been studied. We evaluated 32 sex and age matched patients with advanced AV block who received AV synchronous pacers using either a single lead with diagonally arranged bipole (Unity VDDR, Model 292, Intermedics Inc.) or closely spaced bipolar complete ring electrodes (Thera VDD, Model 8948, Medtronic Inc.). The total surface area of the atrial electrodes were 17.2 and 25 mm2, and the highest programmable atrial sensitivities were 0.1 and 0.25 mV, respectively. Atrial electrogram amplitude and sensing threshold were evaluated at implant and at each follow-up clinic visit (1, 3, and 6 months). Stability of atrial sensing was assessed during physical maneuvers, treadmill exercise test, and Holter recording. Atrial electrogram amplitude at implantation was higher in the Thera VVD (2.08 +/- 0.79 vs 1.45 +/- 0.59 mV in Unity VDDR; P < 0.05), but the value of atrial sensing threshold was lower during follow-up than Unity VDDR. P wave undersensing was additionally observed with both pacemakers during physical maneuvers and exercise testing (6%-...Continue Reading
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