title: Single lead DDD pacing using electrodes with longitudinal and diagonal atrial floating dipoles.
abstract: In this study, an assessment was made of the possibilities of single lead DDD pacing in two groups: a group of 15 patients in whom a lead with a longitudinal atrial "floating" dipole was implanted, and another group of 10 patients with a lead with a diagonal atrial "floating" dipole. In both groups, the electrodes were connected to a SLD generator. At discharge, atrial capture was achieved with the unipolar mode in 17 of 25 patients, whereas in the group carrying the longitudinal atrial dipole, atrial capture was achieved with the overlapping biphasic impulses (OLBI) system in 12 of 15 patients and in all 10 patients in the group with the diagonal atrial dipole. At 3 months, atrial capture was achieved with the unipolar mode in 13 of 22 patients (5.75 +/- 1.77 V/0.5 ms), whereas with the OLBI system atrial capture was achieved in 8 of 13 patients carrying the longitudinal atrial dipole (3.11 +/- 1.13 V/0.5 ms), and in 8 of the 9 patients carrying the diagonal atrial dipole (2.80 +/- 0.69 V/0.5 ms). In this study, the use of the OLBI system led to a significant reduction of atrial threshold (P < 0.0001). Phrenic stimulation is the main untoward effect reported during single lead DDD pacing, a lower incidence being detected in the group carrying the diagonal atrial dipole (10 vs 35.7%, P = NS). Other limitations of this form of pacing could result from a crossed stimulation phenomenon detected in a patient during single lead DDD pacing.
authors.affiliation: Service of Cardiology, Zaragoza University Clinic Hospital. rizqui@wanadoo.es
authors.forename: Ricardo
authors.initials: R
authors.lastname: Izquierdo
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Rodrigo
authors.forename: Juana
authors.initials: J
authors.lastname: Pelegrin
authors.forename: Antonio
authors.initials: A
authors.lastname: Sánchez
authors.forename: Ricardo
authors.initials: R
authors.lastname: Fajardo
authors.forename: Juan
authors.initials: J
authors.lastname: Vidan
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ferreira
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016280:Atrial Function, Right; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004566:Electrodes; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010138:Pacemaker, Artificial; D010791:Phrenic Nerve; D011187:Posture; D018709:Statistics, Nonparametric