Long-term Comparison of Unipolar and Bipolar Pacing and Sensing, Using a New Multiprogrammable Pacemaker System
- 1 May 1983
- journal article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 6 (3), 592-600
- https://doi.org/10.1111/j.1540-8159.1983.tb05300.x
Abstract
Over a six-month period a comparison was made between uni- and bipolar myocardial stimulation thresholds and R-wave sensitivity in 15 consecutive pacemaker patients. The patients received a new multiprogrammable Cordis 336 A pulse generator, that could be programmed with either uni- or bipolar circuitry. In addition, rate, output, sensitivity and pacing mode could be noninvasively programmed. The occurrence of myopotential interference at different sensitivity levels was also studied. Cordis 325-161 bipolar endocardial leads were used in all patients. In one patient, the current output sometimes had to be programmed higher bipolarly than unipolarly to capture the ventricles, otherwise no differences in threshold were found. Acutely. R-wave sensitivity was superior in 9 patients (60%) in the bipolar mode. Unipolar and bipolar electrograms were equal in 4 (26.7%), whereas unipolar R-wave sensitivity was best in only 2 (13.3%) of the patients. At a six-month follow-up, the same tendency was found. In 5 patients, bipolar sensing was superior to unipolar, while anti- and bipolar sensitivity was equal in the remaining patients. Myopotential inhibition was never seen in the bipolar mode at highest sensitivity (0.8 mV) even during provocative tests (n = 15) or 24-hour Holter monitoring (n = 12). In the unipolar mode, 14/15 patients (93.3%) showed inhibition during provocative tests and 12/12 patients (100%) during monitoring at a programmed sensitivity of 0.8 mV. No patients had myopotential interference at a sensitivity level of 3.5 mV. All patients have their pacemakers programmed in the bipolar mode after six months. This study confirms earlier acute data that the bipolar pacing mode is superior to the unipolar mode for permanent pacemaker therapy.Keywords
This publication has 16 references indexed in Scilit:
- Time Dependence of Unipolar Cathodal and Anodal Strength‐Interval CurvesPacing and Clinical Electrophysiology, 1980
- Myopotential Inhibition of Unipolar QRS‐inhibited (VVI) Pacemakers, Assessed by Ambulatory Holter Monitoring of the ElectrocardiogramPacing and Clinical Electrophysiology, 1980
- The Interdependence Between Electrogram, Total Electrode Impedance and Pacemaker Input Impedance Necessary to Obtain Adequate Functioning of Demand PacemakersPacing and Clinical Electrophysiology, 1979
- Cardiac Pacing, Data Collection and World SurveysPacing and Clinical Electrophysiology, 1979
- A comparison of unipolar and bipolar electrograms for cardiac pacemaker sensing.Circulation, 1977
- Vulnerability of the mildly ischemic ventricle to cathodal, anodal, and bipolar stimulation.Circulation Research, 1977
- Ventricular fibrillation induced by a unipolar implanted pacemaker (cathodal stimulation)American Heart Journal, 1976
- Interference effect of myopotenitals on function of unipolar demand pacemakers.Heart, 1974
- Unterdrückung von Demand-Schrittmachern durch MuskelpotentialeDeutsche Medizinische Wochenschrift (1946), 1972
- The Excitability Cycle of the Dog's Left Ventricle Determined by Anodal, Cathodal, and Bipolar StimulationCirculation Research, 1956