Multicenter clinical experience with an atrial lead designed to minimize far-field R-wave sensing

• Published in: Europace (London, England) England), 2009-05, Vol.11 (5), p.618-624
• Main Authors: Fung, Jeffrey W.H., Sperzel, Johannes, Yu, Cheuk Man, Chan, Joseph Y.S., Gelder, Robert N., Yang, Michael X., Rooke, Ryan, Boileau, Peter, Fröhlig, Gerd
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Atrial Fibrillation - physiopathology; Atrial Fibrillation - therapy; Electrocardiography; Electrocardiography, Ambulatory; Equipment Design; Female; Foreign-Body Migration; Heart Atria - physiopathology; Humans; Male; Middle Aged; Pacemaker, Artificial - adverse effects; Sensitivity and Specificity
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/eup078

Aims To evaluate a novel atrial lead designed to reduce far-field sensing. Methods and results Sixty-three patients with standard pacing indications were randomized to receive an OptiSense™ 1699T (St Jude Medical, USA) or conventional pacing lead in the right atrium. Post-implant follow-up was conducted for all patients at 90 days and for a subset at 360 days. Standard electrical parameters were measured. Thresholds of sensing were determined for far-field ventricular signals. The number of inappropriate mode switches was determined from the stored intracardiac electrogram (IEGM). At 90 days, an IEGM Holter recorded 24 h of IEGM. With atrial sensitivity programmed at 0.3 mV, no far-field sensing occurred in the OptiSense™ group, but it did occur in 20% and 30% of the control group at 90 and 360 days, respectively. Inappropriate mode switching was observed in 4% of the OptiSense™ group in contrast to 23% of the control group. The IEGM Holter found no far-field sensing in the OptiSense™ group, but did find 83 023 far-field events from 22% of control patients. The standard electrical parameters of the OptiSense™ leads were acceptable. Conclusion The OptiSense™ lead reduced ventricular far-field sensing in the atrium while maintaining satisfactory pacing and sensing performance, resulting in less inappropriate mode switch.