Oct 1, 1989

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

Pacing and Clinical Electrophysiology : PACE
R D ThroneL A DiCarlo


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

  • References13
  • Citations23

Mentioned in this Paper

Cardiac Chamber Structure
Sinus - General Anatomical Term
Atrial Fibrillation
Signal Processing, Digital
Artificial Cardiac Pacemaker
Atrial Myxoma, Familial
Electrophysiology (Science)
Atrial Depolarization
Heart Ventricle

About this Paper

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.


Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.