Feasibility and sensing thresholds of temporary single-lead VDD pacing in intensive care

The American Journal of Cardiology
T VoigtländerJ Meyer

Abstract

Long-term pacemaker treatment of patients with a high-degree atrioventricular (AV) block routinely uses AV synchronous pacing because of its hemodynamic advantages compared with VVI pacing. In cases of temporary pacing, however, the limitations inherent in attempting to reliably position a temporary atrial lead generally influences the use of VVI pacing. We therefore tested the use of temporary single-lead VDD pacing, making AV pacing possible with only 1 lead, in 22 patients requiring temporary pacing due to a high-degree AV block. AV synchronous stimulation was achieved in all patients using a quadripolar lead with an atrial dipole with the atrial rings spaced 30 mm apart. During follow-up (14.1 +/- 12.5 hours) intermittent undersensing was detected in 4 of the 22 patients. We initially evaluated the atrial sensing threshold by decreasing the pacemaker device sensitivity stepwise in all patients (1.54 +/- 1.08 mV; n = 22). In 15 patients an intra-atrial electrocardiogram was recorded. During the breathing cycle, the maximum P-wave amplitude was significantly different from the minimum P-wave amplitude (2.19 +/- 1.00 mV vs 1.25 +/- 0.65 mV, p < 0.005). The atrial signal detected by the single lead was further analyzed in 10 of...Continue Reading

References

Nov 1, 1992·Pacing and Clinical Electrophysiology : PACE·G E AntonioliT Toselli
Mar 1, 1989·Pacing and Clinical Electrophysiology : PACE·R R Brownlee
Feb 1, 1988·The American Journal of Cardiology·D E RedikerJ W Harthorne
May 1, 1995·The American Journal of Cardiology·B NowakJ Meyer
Sep 1, 1994·Pacing and Clinical Electrophysiology : PACE·G E Antonioli
Sep 1, 1996·Pacing and Clinical Electrophysiology : PACE·B NowakJ Meyer

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Citations

Jan 4, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Antoine LepillierThomas Lavergne

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