Discrimination of retrograde from anterograde atrial activation using intracardiac electrogram waveform analysis.

Pacing and Clinical Electrophysiology : PACE
R D ThroneL A DiCarlo

Abstract

The prevention of pacemaker-mediated tachycardias requires a safe, reliable method for distinguishing retrograde from anterograde atrial activation by dual chamber pacemakers. In this study, a technique was developed to detect the morphological change that occurs in the waveform of the intra-atrial electrogram during retrograde atrial activation. The method employed for waveform analysis is based upon statistical correlation. In 19 patients undergoing electrophysiological studies, atrial electrograms were recorded from bipolar endocardial electrodes during sinus rhythm and 1:1 retrograde atrial depolarization while undergoing right ventricular pacing. Data were digitally sampled at 750, 1,000, and 1,500 Hz. Templates of anterograde atrial depolarization were constructed by signal averaging waveforms from an initial sinus rhythm passage. These were used for analysis of anterograde depolarizations from a subsequent passage of sinus rhythm and a passage of known retrograde atrial depolarization. In all 19 cases, a patient-specific threshold could be derived to separate anterograde from retrograde atrial depolarizations using 1,000 Hz and 1,500 Hz sampling rates. However, at a sampling rate of 750 Hz, separation of anterograde from...Continue Reading

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Citations

Oct 14, 2010·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Sami PakarinenLauri Toivonen
Oct 1, 1991·Journal of the American College of Cardiology·E P GerstenfeldS Swiryn
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Jan 1, 1993·Pacing and Clinical Electrophysiology : PACE·C M ChiangP C Li
Dec 11, 1997·Pacing and Clinical Electrophysiology : PACE·S A StevensonL A DiCarlo
Dec 11, 1997·Pacing and Clinical Electrophysiology : PACE·F Di GregorioA Vincenti
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Sep 5, 1994·Journal of Interventional Cardiology·L DiCarloB Pariseau
Aug 1, 1994·Pacing and Clinical Electrophysiology : PACE·C M ChiangL A DiCarlo

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