Document Detail

Performance evaluation of a right atrial automatic capture verification algorithm using two different sensing configurations.
MedLine Citation:
PMID:  19422578     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This acute data collection study evaluated the performance of a right atrial (RA) automatic capture verification (ACV) algorithm based on evoked response sensing from two electrode configurations during independent unipolar pacing. METHODS: RA automatic threshold tests were conducted. Evoked response signals were simultaneously recorded between the RA(Ring) electrode and an empty pacemaker housing electrode (RA(Ring)-->Can) and the electrically isolated Indifferent header electrode (RA(Ring)-->Ind). The atrial evoked response (AER) and the performance of the ACV algorithm were evaluated off-line using each sensing configuration. An accurate threshold measurement was defined as within 0.2 V of the unipolar threshold measured manually. Threshold tests were designed to fail for small AER (< 0.35 mV) or insufficient signal-to-artifact ratio (SAR < 2). Manual threshold measurements were obtained during RA unipolar and bipolar pacing and compared across device indications. RESULTS: Data were collected from 38 patients with RA bipolar leads from four manufacturers. AER signals were analyzed from 34 patients who were indicated for a pacemaker (five), implantable cardioverter-defibrillator (11), or cardiac resynchronization therapy pacemaker (six) or defibrillator (12). The minimum AER amplitude was larger (P < 0.0001) when recorded from RA(Ring)-->Can (1.6+/-0.9 mV) than from RA(Ring)-->Ind (1.3+/-0.8 mV). The algorithm successfully measured the pacing threshold in 96.8% and 91.0% of tests for RA(Ring)-->Can and RA(Ring)-->Ind, respectively. No statistical difference between the unipolar and bipolar pacing threshold was observed. CONCLUSIONS: The RA(Ring)-->Can AER sensing configuration may provide a means of implementing an independent pacing/sensing method for ACV in the RA. RA bipolar pacing therapy based on measured RA unipolar pacing thresholds may be feasible.
Johannes Sperzel; Stephan Goetze; Charles Kennergren; Mauro Biffi; M Jason Brooke; Elisa Vireca; Sunipa Saha; Bernd Schubert; Christian Butter
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  32     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-08     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  579-87     Citation Subset:  IM    
Kerckhoff-Klinik GmbH, Kardiologie, Abt. Elektrophysiologie, Bad Nauheim, Germany.
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MeSH Terms
Atrial Fibrillation / diagnosis*,  prevention & control*
Cardiac Pacing, Artificial / methods*
Diagnosis, Computer-Assisted / methods*
Electrocardiography / methods*
Pattern Recognition, Automated / methods*
Reproducibility of Results
Sensitivity and Specificity
Therapy, Computer-Assisted / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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