Document Detail


The use of implantable sensors for the control of pacemaker mediated tachycardias: a comparative evaluation between minute ventilation sensing and acceleration sensing dual chamber rate adaptive pacemakers.
MedLine Citation:
PMID:  1370998     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The role of implantable sensors to control pacemaker mediated tachycardias was investigated in 16 patients with two different dual chamber rate adaptive (DDDR) pacemakers, which sensed eiter minute ventilation (DDDR-Meta, nine patients) or body acceleration (Relay, seven patients). Successive atrial sensed events beyond a programmable rate occurring in the absence of detection of exercise by the sensors were considered to represent retrograde conduction or atrial arrhythmias, and the pacemakers responded by either a mode shift from DDDR to ventricular rate adaptive (VVIR) pacing (DDDR-Meta) or by tracking at an interim rate, the so-called conditional ventricular tracking limit (CVTL, Relay). In the unipolar atrial sensing mode, myopotential sensing (MPI) and external chest wall stimulations (CWS) at 250 beats/min were induced to be preferentially sensed by the atrial channel to simulate the conditions of atrial arrhythmias. In the DDD mode, these maneuvers resulted in ventricular responses of 88 +/- 3 beats/min and 110 +/- 3 beats/min for MPI and CWS, respectively. The pacing rate was significantly reduced in the DDDR mode with the sensors correctly detecting and responding to the sensed abnormal atrial signals (68 +/- 5 beats/min during MPI and 71 +/- 5 beats/min during CWS, P less than 0.005 compared with the corresponding DDD rate). One patient with a Relay pacemaker developed spontaneous atrial flutter and the ventricular tracking responses were 140 and 85 beats/min in the DDD and DDDR pacing modes, respectively. Thus MPI and CWS are useful bedside testing methods to assess pacemaker response during atrial arrhythmias. The use of implantable sensors to judge the appropriateness of atrial rate is a new approach to the management of pacemaker mediated tachycardias.
Authors:
C P Lau; Y T Tai; P C Fong; J P Li; F L Chung; S Song
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  15     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-03-12     Completed Date:  1992-03-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  34-44     Citation Subset:  IM    
Affiliation:
Department of Medicine, Queen Mary Hospital, Hong Kong.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Algorithms*
Cardiac Pacing, Artificial / methods*
Electrocardiography
Electrodes, Implanted
Equipment Design
Evaluation Studies as Topic
Female
Humans
Male
Middle Aged
Pacemaker, Artificial*
Tachycardia / etiology,  therapy*

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


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