Multicenter clinical experience with an atrial lead designed to minimize far-field R-wave sensing.
OBJECTIVE
To evaluate a novel atrial lead designed to reduce far-field sensing.


RESULTS
Sixty-three patients with standard pacing indications were randomized to receive an OptiSense 1699T (St Jude Medical, USA) or conventional pacing lead in the right atrium. Post-implant follow-up was conducted for all patients at 90 days and for a subset at 360 days. Standard electrical parameters were measured. Thresholds of sensing were determined for far-field ventricular signals. The number of inappropriate mode switches was determined from the stored intracardiac electrogram (IEGM). At 90 days, an IEGM Holter recorded 24 h of IEGM. With atrial sensitivity programmed at 0.3 mV, no far-field sensing occurred in the OptiSense group, but it did occur in 20% and 30% of the control group at 90 and 360 days, respectively. Inappropriate mode switching was observed in 4% of the OptiSense group in contrast to 23% of the control group. The IEGM Holter found no far-field sensing in the OptiSense group, but did find 83 023 far-field events from 22% of control patients. The standard electrical parameters of the OptiSense leads were acceptable.


CONCLUSIONS
The OptiSense lead reduced ventricular far-field sensing in the atrium while maintaining satisfactory pacing and sensing performance, resulting in less inappropriate mode switch.
Fung
Jeffrey W H
JW
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China. jwhfung@cuhk.edu.hk
Sperzel
Johannes
J
Yu
Cheuk Man
CM
Chan
Joseph Y S
JY
Gelder
Robert N
RN
Yang
Michael X
MX
Rooke
Ryan
R
Boileau
Peter
P
Fröhlig
Gerd
G
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000628:therapy*; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D004867:Equipment Design; D005260:Female; D005548:Foreign-Body Migration; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects; D012680:Sensitivity and Specificity