The Impact of the Distance between the Atrial Electrode and the Atrial Wall on Atrial Undersensing in Patients with VDD Pacemakers: Long-Term Follow-Up

Aim: Atrial undersensing (AUS) in single‐lead VDD pacemakers may be due to diminished P‐wave amplitude secondary to local inflammation beneath the electrodes closer to atrial wall. The aim of this study was to assess the potential effect of distance between atrial electrode and atrial wall on immedi...

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Bibliographic Details
Published in:Annals of noninvasive electrocardiology 2008-10, Vol.13 (4), p.332-340
Main Authors: Altin, Timucin, Guldal, Muharrem, Candemir, Basar, Polat, Cegerhun, Ozdemir, Aydan O., Tulunay, Cansin, Ozdol, Cagdas, Akyurek, Omer, Karaoguz, Remzi, Erol, Cetin
Format: Article
Language:English
Subjects:
atrial electrode
atrial undersensing
atrial wall
Electrocardiography
Electrodes, Implanted
Female
Follow-Up Studies
Heart Atria - physiopathology
Humans
Male
Middle Aged
Original
Pacemaker, Artificial
VDD pacemakers
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Summary:Aim: Atrial undersensing (AUS) in single‐lead VDD pacemakers may be due to diminished P‐wave amplitude secondary to local inflammation beneath the electrodes closer to atrial wall. The aim of this study was to assess the potential effect of distance between atrial electrode and atrial wall on immediate and long‐term atrial sensing stability in VDD systems. Methods: A total of 275 patients with normal sinus node function who received VDD pacemakers were enrolled into the study and were followed up for a median duration of 33 months. During each control visit, a standard 12‐lead electrocardiogram (ECG) was obtained and standard pacemaker function assessment was performed including testing for pacing threshold and atrioventricular synchrony. The distance between atrial electrode and atrial wall was measured from chest X‐ray. Results: Of the 275 patients, AUS was detected in 59 patients. Univariate predictors of AUS were use of closely spaced bipolar ring atrial electrode (CSBR) (P = 0.01), wider atrial ring‐spacing (P = 0.03), and atrial sensitivity programmed to a higher level (P = 0.001). Use of CSBR (P = 0.04) and atrial sensitivity ≥0.3 mV (P = 0.02) were observed to be the independent predictors for AUS. When the distance between atrial electrode and atrial wall was
ISSN:1082-720X
1542-474X
DOI:10.1111/j.1542-474X.2008.00243.x