title: Evolution of atrial signals from a single lead VDD pacemaker. AddVent European Multicentre Study Group.
abstract: The atrial sensing capabilities of a new single pass lead VDD pacing system (Pacesetter AddVent) were assessed in a prospective multicenter study of 101 implants during the period July 1994 through March 1996. The pacing lead (Pacesetter AV Plus) has a unique quadripolar 4-in-line connector and uses a pair of ring electrodes with an interelectrode spacing of 12 mm for atrial sensing. The mean age of the patients (51 men) was 73 years (range 19-91). Seventy-five patients had complete heart block; the others had 2:1 AV block. Wide variations were found in signal amplitude: mean P wave amplitude, measured over four cycles in the supine position, was 2.4 +/- 1.9 mV at implant, dropping to 1.9 +/- 1.7 mV predischarge, and remaining constant at follow-up but with a narrower range. Holter monitoring was undertaken in 24 patients, with a total of 550 monitored hours. Mean AV synchrony was 98.2% +/- 4.6% (excluding premature ventricular contractions), with 20 patients (83%) showing > 99% AV synchrony, with atrial sensing at 0.1 mV where needed. No oversensing was observed in any patient. There was a low incidence of atrial fibrillation (2%) and sinus bradycardia (0%). The findings show that the range of atrial signals, although wide initially, converges over the first year and remains adequate for reliable AV synchronous pacing.
authors.affiliation: Bristol Heart Institute, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Papouchado
authors.forename: J C
authors.initials: JC
authors.lastname: Crick
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001146:Arrhythmia, Sinus / Q000209:etiology; D001281:Atrial Fibrillation / Q000209:etiology; D016275:Atrial Function; D001283:Atrioventricular Node / Q000503:physiopathology; D001919:Bradycardia / Q000209:etiology; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D004566:Electrodes; D004867:Equipment Design; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D015203:Reproducibility of Results; D016683:Supine Position; D018879:Ventricular Premature Complexes / Q000503:physiopathology / Q000628:therapy