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Initial Clinical Experience with a Single Pass VDDR Pacing System
Author(s) -
LAU CHUPAK,
TAI YAUTING,
LI JOHN POSHAN,
CHUNG FELSA LAIWAH,
SUNG STELLA,
YAMAMGTO ALLAN
Publication year - 1992
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.1540-8159.1992.tb02989.x
Subject(s) - medicine , cardiology , ventricular pacing , atrioventricular block , ventricular rate , heart rate , lead (geology) , cardiac pacing , anesthesia , heart failure , blood pressure , geomorphology , geology
Although ventricular rate adaptive pacing (VVIR) improves exercise capacity and cardiac output compared to constant rate ventricular pacing (WI), this pacing mode does not provide benefit of atrioventricular (AV) synchrony. We evaluated the use of a custom‐built VDDR pacing system using a single pass, ventricular lead, which detects end cavity P wave using a pair of diagonally arranged atrial bipolar (DAB) electrodes. In the VDDR mode, AV synchrony is enabled and the P wave rate is used in conjunction with an accelerometer based activity sensor for rate adaptive pacing. A VDDR pacemaker was implanted in three patients with complete AV block (mean age 63 ± 1 year) and the mean implantation time was 29 minutes. Mean P wave amplitude was 2.4 mV (1.2–4.2 mV) at implantation and telemeter P wave amplitude was stable over a follow‐up of 6 months. At a sensitivity of 0.2 mV, stable P wave sensing was observed during breathing maneuvers, arm swinging, my potential induction, and Holter recording. Paired exercise tests performed in the VDDR and VVIR modes showed higher cardiac output at rest, during exercise, and in the recovery period in the VDDR pacing mode. Thus VDDR pacing using a single pass lead is superior to VVIR pacing by enabling P synchronous ventricular pacing without adding to the complexity of implantation.