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Clinical Evaluation of VDD Pacing with a Unipolar Single‐Pass Lead
Author(s) -
CORNACCHIA DANIELE,
FABBRI MAURO,
MARESTA ALEARDO,
GRASSI GINO,
VAIANI PAOLO
Publication year - 1989
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1989.tb02706.x
Subject(s) - medicine , lead (geology) , cardiology , atrium (architecture) , artificial cardiac pacemaker , electrode , qrs complex , ventricular pacing , heart failure , atrial fibrillation , chemistry , geomorphology , geology
Twenty patients with advanced AV block and normal sinus node function underwent pacemaker implantation, randomly receiving a CPI 910 ULTRA II model VDD pacemaker. The first 13 patients received the implantation of a single lead with a screw‐in positive ventricular fixation tip and a unipolar ring floating atrial electrode spaced 13 cm from the tip. A subsequent group of seven patients received a conventional porous tinned‐tip lead with a pair of unipolar ring floafing electrodes. The second solution was adopted because the best atrial signal was not always in the high or mid‐high atrium portion, but sometimes in the middle or mid‐low position. With the modified double‐electrode lead, the floating atrial electrode that detects the best signal can be selected, cutting out the pin of the one not used. The comparisons between minimal atrial slew rate and maximal ventricular slew rate, as well as those between minimal P wave amplitude and maximal R wave amplitude, show a highly significant range difference, as large as P < 0.01. Surface electrocardiograms, stress tests, and 24‐hour Holter monitoring showed the correct functioning of the system with an average sensing failure from 0.05 to 1%. In conclusion, VDD stimulation is feasible with a single unipolar lead and a floating atrial electrode in conjunction with a pacemaker generator (CPI 910 ULTRA II) originally designed for permanent twin‐lead implantation.