title: Feasibility of customised unipolar conversion using bipolar temporary pacing wires in patients after surgical repair of congenital heart disease.
abstract: OBJECTIVE
  Temporary pacing wires play a crucial role in the diagnosis and therapy of post-operative arrhythmia after surgery for congenital heart disease. At present, bipolar pacing wires are used in most institutions. In case of functional failure of these wires, a unipolar mode of stimulation and sensing should be theoretically possible as a rescue procedure.
  
  
  METHODS
  We tested the feasibility of the customised unipolar mode in 18 post-operative patients with congenital heart disease (age 9.2 ± 13.9 months, weight 6.3 ± 3.8 kg, and cardiopulmonary bypass time 70 ± 29 minutes). As there are two possible unipolar configurations, there are twice the number of testing parameters; of those, we compared sensing (mV) and pacing thresholds (V at 0.5 ms).
  
  
  RESULTS
  Atrial sensing was significantly better in the unipolar modes (p < 0.001, p < 0.003). The ventricular unipolar sensing did not differ significantly in the "better" of the two possible configurations from the bipolar values (p = 0.363). For the unipolar pacing thresholds, only the "better" unipolar configuration did not differ significantly from the bipolar measurements (atrial: p = 0.058, ventricular: p = 0.138). There was no exit block or undersensing.
  
  
  CONCLUSIONS
  The results demonstrate that unipolar stimulation and sensing using bipolar epicardial temporary pacing wires is feasible. In the case of failure of bipolar temporary pacing wires, this modality represents an easy rescue measure that in such cases should always be considered.
authors: Department of Congenital Heart Disease and Pediatric Cardiology,Deutsches Herzzentrum Berlin,Berlin,Germany.
authors: Bjoern
authors: B
authors: Peters
authors: Department of Congenital Heart Disease and Pediatric Cardiology,Deutsches Herzzentrum Berlin,Berlin,Germany.
authors: Oliver
authors: O
authors: Miera
authors: Department of Congenital Heart Disease and Pediatric Cardiology,Deutsches Herzzentrum Berlin,Berlin,Germany.
authors: Peter
authors: P
authors: Ewert
authors: Department of Congenital Heart Disease and Pediatric Cardiology,Deutsches Herzzentrum Berlin,Berlin,Germany.
authors: Sevim
authors: S
authors: Yilmaz
authors: Department of Congenital Heart Disease and Pediatric Cardiology,Deutsches Herzzentrum Berlin,Berlin,Germany.
authors: Felix
authors: F
authors: Berger
authors: Department of Congenital Heart Disease and Pediatric Cardiology,Deutsches Herzzentrum Berlin,Berlin,Germany.
authors: Boris
authors: B
authors: Schmitt
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002675:Child, Preschool; D015331:Cohort Studies; D004567:Electrodes, Implanted; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D007223:Infant; D008297:Male; D010138:Pacemaker, Artificial; D011184:Postoperative Period