Document Detail

Single-lead VDD pacing system.
MedLine Citation:
PMID:  1695356     Owner:  NLM     Status:  MEDLINE    
A single pass ventricular lead with a dual chamber electrode system, designed for VDD pacing, was implanted in 17 patients (11 men, 6 women, aged 53 to 86 years, mean 74) for symptomatic bradycardia due to second-or third-degree AV block and normal sinus node function. Bipolar atrial electrodes, diagonally displaced along the lead axis and positioned within the right atrial cavity, are used to detect atrial activity that is then differentially processed within the pacemaker. P wave amplitude (amp) derived from a PSA-DAA device at implant was 1.38 +/- 0.28 mV. P wave signal amp derived from telemetered atrial electrograms was 1.29 +/- 0.22 mV at predischarge (n = 17), 1.31 +/- 0.24 mV at 3 months (n = 15), 1.30 +/- 0.24 mV at 6 months (n = 8), 1.51 +/- 0.34 mV at 9 months (n = 4), and 1.35 +/- 0.35 mV at 12 months (n = 2); and the far-field QRS signal measured at predischarge was of negligible voltage (0.17 +/- 0.07 mV). The susceptibility of the atrial sensor system to interference was noted with chest wall stimulation and only at higher sensitivities (0.1 to 0.3 mV) and not with isometric arm exercise. Intact VDD pacing function at rest and during exercise was established using Holter and periodic ECG monitoring. Postoperative complications included one lead displacement and one pocket hematoma. Three patients died postimplant of causes unrelated to pacemaker function. Advantages of the single-lead VDD pacing include: (1) elimination of second atrial sensing lead; (2) superior atrial sensing performance; (3) effective resistance to myopotential and far-field signal interference; and (4) stability of postimplant atrial signal amplitude.
P Varriale; A G Pilla; M Tekriwal
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Publication Detail:
Type:  Comment; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  13     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1990 Jun 
Date Detail:
Created Date:  1990-08-23     Completed Date:  1990-08-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  757-66     Citation Subset:  IM    
Division of Cardiology, Cabrini Medical Center, New York, New York 10003.
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MeSH Terms
Aged, 80 and over
Bradycardia / etiology,  therapy*
Cardiac Pacing, Artificial / methods*
Electrocardiography, Ambulatory
Electrodes, Implanted
Equipment Design
Exercise / physiology
Follow-Up Studies
Heart Block / complications
Middle Aged
Pacemaker, Artificial*
Time Factors
Comment On:
Pacing Clin Electrophysiol. 1990 Dec;13(12 Pt 1):1686   [PMID:  1704524 ]
Comment In:
Pacing Clin Electrophysiol. 1990 Dec;13(12 Pt 1):1686   [PMID:  1704524 ]

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

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