Document Detail

Atrial near-field and ventricular far-field analysis by automated signal processing at rest and during exercise.
MedLine Citation:
PMID:  16630085     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Sophisticated monitoring of atrial activity is a prerequisite for modern pacemaker therapy. Ideally, near-fields and ventricular far-fields ought to be distinguished by beat-to-beat template analysis of the atrial signal. A prerequisite is that atrial signals are stable under different conditions. METHODS AND RESULTS: A Matlab routine was developed to analyze atrial electrograms of 23 patients at least 3 months after implantation of a dual chamber pacemaker under several conditions including at rest, bipolar at rest, in an upright position, during treadmill exercise, and postexercise. A near-field and far-field template was created and amplitudes, widths, and slew rates were measured. In bipolar configuration, near-field amplitude at rest was 3.04 +/- 0.94 mV (unipolar)/3.36 +/- 1.0 mV (bipolar) versus 3.18 +/- 1.0 mV (bipolar) at peak exercise. Far-field amplitude at rest was 1.66 +/- 1.18 (unipolar)/0.47 +/- 0.27 mV (bipolar) and 0.41 +/- 0.21 mV (bipolar) at peak exercise (n.s. for bipolar measurements). No overall significant changes were observed for near- and far-field widths and slew rates during exercise. Shorter tip-ring distances of the atrial bipole, lead position, and the presence of sinus node disease did not have any impact on overall near- and far-field signal characteristics. Intraindividual differences between rest and peak exercise were moderate (range: near-field +0.15 to -0.54 mV; range: far-field +0.05 to -0.18 mV). CONCLUSIONS: Atrial near and far fields can be automatically classified and quantified by automated signal processing. Signals did not change during exercise or change of posture. This is a prerequisite for the implementation of beat-to-beat template analysis into pacemakers.
Frank Eberhardt; Hendrik Bonnemeier; Martin Lipphardt; Ulrich G Hofmann; Heribert Schunkert; Uwe K H Wiegand
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  11     ISSN:  1082-720X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-24     Completed Date:  2006-06-02     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  118-26     Citation Subset:  IM    
University Hospital Schleswig Holstein, Campus Luebeck, Medicine II, Luebeck, Germany.
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MeSH Terms
Atrial Fibrillation / diagnosis*,  physiopathology
Exercise Test / methods*
Feasibility Studies
Pacemaker, Artificial*
Signal Processing, Computer-Assisted
Statistics, Nonparametric
Ventricular Fibrillation / diagnosis*,  physiopathology

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