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.
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
Jeffrey W H
JW
Fung
Johannes
J
Sperzel
Cheuk Man
CM
Yu
Joseph Y S
JY
Chan
Robert N
RN
Gelder
Michael X
MX
Yang
Ryan
R
Rooke
Peter
P
Boileau
Gerd
G
Fröhlig
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