Analysis of Atrial Sensed Far‐Field Ventricnlar Signals: A Reassessment
- 1 April 1997
- journal article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 20 (4), 916-922
- https://doi.org/10.1111/j.1540-8159.1997.tb05494.x
Abstract
Accurate detection of the spontaneous far-field ventricular signal may be used to determine the ventricular activation, and hence, the interval from atrial stimulus to the ventricular R wave (AR interval) using a standard atrial pacing lead. This can be useful in developing a physiological atrial rate responsive (AAIR) pacemaker and in further improving DDD(R) pacing algorithms. In order to better characterize the atrial sensed far-field ventricular signal, 200 consecutive patients undergoing pacemaker implantation were studied. The amplitude of the far-field ventricular signal was significantly smaller than that of the atrial deflection. In all recordings, the slew rate of the atrial deflection was larger than that of the far-field ventricular signal. Subdivision of the recordings by electrode position, pocket location, or QRS duration on the surface ECG resulted in significantly different signal characteristics. The amplitude and slew rate of the far-field ventricular signal were significantly smaller in bipolar versus unipolar sensing. Atrial sensed far-field ventricular recordings could also be obtained in the case of ventricular pacing. Our results indicate that accurate sensing of the far-field ventricular signal from an atrial pacing lead is conceivable in most patients. The different signal characteristics in relation to parameters, such as electrode position, sensing mode, and pocket location, may be useful in determining the optimal conditions for signal sensing.Keywords
This publication has 10 references indexed in Scilit:
- The Clinical Relevance of Electromyopotential Oversensing in Current Unipolar DevicesPacing and Clinical Electrophysiology, 1992
- The A-R Interval as Exercise Indicator: A New Option for Rate Adaptation in Single and Dual Chamber PacingPacing and Clinical Electrophysiology, 1990
- Far-Field QRS Complex Sensing Via the Atrial Pacemaker Lead. II. Prevalence, Clinical Significance and Possibility of Intraoperative Prediction in DDD Pacing.Pacing and Clinical Electrophysiology, 1988
- Far‐Field QRS Complex Sensing Via the Atrial Pacemaker Lead. I. Mechanism, Consequences, Differential Diagnosis and Countermeasures in AAI and VDD/DDD PacingPacing and Clinical Electrophysiology, 1988
- Utility of the Atrial Endocardial Electrogram Concurrent with Dual-Chamber Pacing in the Determination of a Pacemaker-Mediated ArrhythmiaPacing and Clinical Electrophysiology, 1988
- Differential Bipolar Sensing of a Dual Chamber PacemakerPacing and Clinical Electrophysiology, 1988
- The effect of electrode position on atrial sensing for physiologically responsive cardiac pacemakersAmerican Heart Journal, 1984
- Sensing Characteristics of the Right Atrial Appendage ElectrodePacing and Clinical Electrophysiology, 1983
- Spectral Properties of Atrial and Ventricular Endocardial SignalsPacing and Clinical Electrophysiology, 1979
- Permanent Pervenous Atrial Pacing From the Coronary VeinCirculation, 1974