Variation in P wave amplitude immediately after pacemaker implantation: possible mechanism and implications for early programming.

Pacing and Clinical Electrophysiology : PACE
A H ShandlingJ C Messenger

Abstract

The P wave amplitude (PWA) plays an important role in determining atrial sensing capabilities. To assess early PWA change, we compared the unipolar PWA in 43 patients at the time of atrial lead placement, measured by a pacing systems analyzer, to the unipolar PWA recorded at the end of pacemaker surgery, from telemetered atrial endocardial electrograms. Individual PWA varied from a decrease of 5.2 mV to an increase of 2 mV (-63% to 267%). In 33 patients with active fixation leads, the implant PWA was 1.96 +/- 0.99 mV versus 2.4 +/- 1.4 mV after surgery. In 11 patients with passive fixation leads, the implant PWA was 2.8 +/- 1.9 mV versus 1.9 +/- 0.8 mV after surgery. The PWA change, measured as the difference between the postsurgical and implant PWA was 0.43 +/- 0.8 mV in active versus -0.86 +/- 1.6 mV in the passive fixation lead groups (P less than 0.05). Considerable change in individual P wave amplitude can therefore occur very early after pacemaker implantation. The direction differs significantly between active (predominantly positive) and passive fixation groups (predominantly negative). These data suggest that an adequate margin of safety is important when initially programming atrial sensitivity, particularly when usin...Continue Reading

References

Mar 1, 1979·Pacing and Clinical Electrophysiology : PACE·T R EngelA D Gonzalez
Jun 1, 1978·British Heart Journal·J S GeddesI P Clements
Jun 1, 1977·American Heart Journal·S FurmanV De Caprio
Sep 1, 1986·Pacing and Clinical Electrophysiology : PACE·E V Platia, J A Brinker
Jan 1, 1985·Pacing and Clinical Electrophysiology : PACE·I M Kruse, B Terpstra
Jan 1, 1985·Pacing and Clinical Electrophysiology : PACE·B E KristenssonL Rydén
Nov 1, 1988·Clinical Cardiology·A S ManolisS J Baptist
Jan 1, 1988·The American Journal of Cardiology·S B BernsteinM H Ellestad
Feb 1, 1988·The American Journal of Cardiology·D E RedikerJ W Harthorne
Mar 1, 1986·Journal of the American College of Cardiology·P T Klementowicz, S Furman
Dec 1, 1985·Journal of the American College of Cardiology·P T Klementowicz, S Furman
Jan 1, 1968·Circulation·J I HaftA N Damato
Jan 1, 1982·Pacing and Clinical Electrophysiology : PACE·S Furman, J A Cooper
Jan 1, 1982·Pacing and Clinical Electrophysiology : PACE·R G Hauser
Sep 1, 1982·Pacing and Clinical Electrophysiology : PACE·L KappenbergerM Turina
Sep 1, 1983·Annals of Internal Medicine·R M LuceriR J Myerburg
Jul 1, 1981·Progress in Cardiovascular Diseases·S S BaroldR A Heinle

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Citations

Nov 21, 2000·The American Journal of Cardiology·J NeuznerJ Sperzel
Feb 22, 2001·International Journal of Cardiology·M RomanòA Grieco
Apr 15, 1990·The American Journal of Cardiology·M de BuitleirF Morady
Oct 6, 1997·Pacing and Clinical Electrophysiology : PACE·C C ChiuR M Hamilton
Jul 1, 1990·Pacing and Clinical Electrophysiology : PACE·E Longo, V Catrini
Jan 1, 1997·Pacing and Clinical Electrophysiology : PACE·S S BaroldR McVenes
Nov 1, 1994·Pacing and Clinical Electrophysiology : PACE·J C ResP Westendorp
Nov 1, 1996·Pacing and Clinical Electrophysiology : PACE·I E OvsyscherC Bondy
Oct 1, 1990·Pacing and Clinical Electrophysiology : PACE·J H WilsonE H Wettenstein
Apr 1, 1991·Pacing and Clinical Electrophysiology : PACE·M P Kleinert
Nov 1, 1992·Pacing and Clinical Electrophysiology : PACE·M BergH Schieffer
Jan 1, 1994·Pacing and Clinical Electrophysiology : PACE·J H WilsonS P Fahner

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