PMID: 11310299Apr 20, 2001Paper

Paradoxical undersensing at a high sensitivity in dual chamber pacemakers

Pacing and Clinical Electrophysiology : PACE
R WillemsH Heidbüchel

Abstract

In view of the evolving indications for device therapy in atrial arrhythmia the accurate detection of high rate atrial events is a necessity. In a sheep model of atrial fibrillation (AF) we observed a contradictory behavior of the Thera DR pacemaker. The pacemakers were programmed to deliver burst pacing on detection of sinus rhythm (SR). Paradoxically, progressively more inappropriate bursts were delivered during AF, at a higher sensitivity. This implied that the pacemaker interpreted AF as SR. We assessed the atrial detection of the Thera DR, Diamond, Saphir, and Marathon pacemakers during AF, in a sheep model and in vitro using a waveform generator. By counting the annotated atrial-sensed events reported by the pacemaker we charted the behavior of the pacemakers at different sensitivities. At a higher sensitivity both the Thera DR and the Diamond paradoxically reported fewer atrial events during AF. This behavior led to inappropriate mode switching and incorrect diagnostic data collection. It could be reproduced in vitro. The Marathon did not show this paradoxical undersensing in vivo or in vitro. This paradoxical undersensing at a high sensitivity is dependent on the amplitude of the input signal and could not be explained ...Continue Reading

Citations

Jul 6, 2005·Herzschrittmachertherapie & Elektrophysiologie·Carsten W Israel, Dmitri Pajitnev
Jul 30, 2005·Journal of Cardiovascular Electrophysiology·Christof KolbClaus Schmitt
Sep 19, 2006·Journal of Cardiovascular Electrophysiology·Berry M Van GelderAlbert Meijer
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Amy L BeemanRobert F Rea
Apr 25, 2017·Pacing and Clinical Electrophysiology : PACE·Johannes C von AlvenslebenKathryn K Collins
Feb 25, 2018·Pacing and Clinical Electrophysiology : PACE·Christopher MonkhouseAnthony Wc Chow

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