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

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

  • References13
  • Citations23

Mentioned in this Paper

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

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