PMID: 8945035Nov 1, 1996Paper

Single lead DDD system: a comparative evaluation of unipolar, bipolar, and overlapping biphasic stimulation and the effects of right atrial floating electrode location on atrial pacing and sensing thresholds

Pacing and Clinical Electrophysiology : PACE
H F TseN Mehta

Abstract

Single lead DDD pacing using unipolar or bipolar stimulation is limited by high atrial threshold. Overlapping biphasic (OLBI) waveform stimulation via atrial floating ring electrodes may preferentially enhance atrial pacing and avoid diaphragmatic pacing. Single lead DDD pacing with OLBI atrial pacing was studied in 12 patients (6 men and 6 women; mean age 74 +/- 7 years) with complete heart block. At implantation, atrial bipolar rings (area 27 mm2, separation 10 mm) were positioned at radiological defined high, mid, and low right atrial (RA) levels, and P wave amplitude and atrial and diaphragmatic pacing thresholds were determined in each position using unipolar, bipolar, and OLBI stimulation in random order. Although statistically insignificant, both the maximum and minimum sensed P wave amplitudes tended to be lower in the low RA position. Independent of the stimulation modes, minimum atrial pacing threshold occurred in the mid-RA. At mid-RA, the atrial pacing threshold was significantly lower with OLBI pacing compared with either unipolar or bipolar mode (3.9 +/- 2.2 V vs 6.7 +/- 3.5 V and 6.9 +/- 3.5 V, P < 0.05). Although the diaphragmatic thresholds were similar, OLBI pacing modes in the mid-RA and final location signif...Continue Reading

References

Nov 1, 1994·Pacing and Clinical Electrophysiology : PACE·J HirschbergS Bowald

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Citations

Feb 1, 1998·Herzschrittmachertherapie & Elektrophysiologie·B NowakJ Meyer
May 8, 2009·Herzschrittmachertherapie & Elektrophysiologie·D HartungW M Hartung
Jun 11, 1999·Journal of the American College of Cardiology·H F TseG M Ayers
Jan 5, 2001·Pacing and Clinical Electrophysiology : PACE·J C ResUNKNOWN European VECATS Multicenter Study Group. The Canadian VECATS Multicenter Study Group
Mar 10, 2000·Cardiology Clinics·G H Crossley
Aug 24, 1999·Pacing and Clinical Electrophysiology : PACE·B NaegeliO Bertel
Oct 20, 1999·Pacing and Clinical Electrophysiology : PACE·C W IsraelN Lokhoff

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