title: Effect of pentaphasic pulse sequence as an impedance sensor on standard electrocardiographic recordings.
abstract: Two advances in cardiac pacing have resulted in an internal conflict in some pacemakers. One is the development of a standard lead physiological sensor and the other is protection from electromagnetic interference (EMI). One popular type of standard lead sensor uses sub-threshold pulses to measure intracardiac and intrathoracic impedance changes, i.e., minute ventilation. Recent clinical observations and extensive in vitro testing have verified that digital cellular phones can be troublesome. Large feedthrough capacitors (FCs), effective in blocking the EMI, will preclude sensing of the standard impedance-based signals. A variety of pulse configurations were studied that might be effective for a sensor-based impedance signal while allowing the pacemaker to continue to use large Fcs protecting them from environmental EMI. In comparison to both monophasic and biphasic pulse sequences, a pentaphasic pulse sequence was effective as an impedance sensor, still allows large FCs to function as an effective filter for environmental EMI, and would not produce artifacts on surface ECG.
authors.affiliation: Advanced Research Division, Pacesetter Inc., St. Jude Medical Company, Sylmar, California, USA.
authors.forename: S
authors.initials: S
authors.lastname: Mortazavi
authors.forename: E
authors.initials: E
authors.lastname: Park
authors.forename: J
authors.initials: J
authors.lastname: Florio
authors.forename: J
authors.initials: J
authors.lastname: Poore
authors.forename: G
authors.initials: G
authors.lastname: Bornzin
authors.forename: P A
authors.initials: PA
authors.lastname: Levine
authors.forename: J
authors.initials: J
authors.lastname: Sholder
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000379:methods; D017097:Electric Impedance; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods*; D004574:Electromagnetic Fields; D004581:Electronics / Q000295:instrumentation; D004582:Electronics, Medical / Q000295:instrumentation*; D004867:Equipment Design; D004868:Equipment Failure; D004869:Equipment Safety; D006321:Heart / Q000502:physiology; D006801:Humans; D010138:Pacemaker, Artificial; D010992:Plethysmography, Impedance / Q000295:instrumentation; D012119:Respiration / Q000502:physiology; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D013689:Telephone; D013909:Thorax / Q000502:physiology