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Clinical Significance of a New P Wave Lead Vector for Pacemaker Follow‐Up of Atrial Functions
Author(s) -
LU RICHARD M.T.,
STEINHAUS BRUCE M.,
BAILEY WILLIAM,
NADEMANEE KOONLAWEE
Publication year - 1996
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.1540-8159.1996.tb03229.x
Subject(s) - lead (geology) , medicine , amplitude , root mean square , cardiology , p wave , clinical practice , square wave , electrophysiology , atrial fibrillation , optics , physics , physical therapy , quantum mechanics , geomorphology , voltage , geology
Patient welfare requires routine follow‐up procedures of implantable pacemakers. However, the assessment of atrial sensing and pacing functions in implantable pacemakers is often a challenge due to difficult identification of low amplitude P waves on surface electrocardiograms (ECGs). A previous body surface mapping study suggested that a novel P wave lead vector (P lead) had larger root mean square values than other standard leads. However, for pacemaker follow‐up procedures, peak‐to‐peak amplitudes are more relevant than root mean square values. In this study, the peak‐to‐peak amplitudes of intrinsic and paced P waves recorded from surface ECG standard lead II and the P lead were compared. In addition, intrinsic and paced R waves were also compared. Data recorded from 15 patients undergoing electrophysiological studies indicated that peak‐to‐peak amplitudes of the P lead were significantly larger than standard lead II: 24% for intrinsic P waves, 30% for paced P waves, and 72% for intrinsic R waves. In addition, the P lead amplitude of paced R waves showed a nonsignificant increase of 24% compared with standard lead II. Therefore, the use of this new lead vector may improve the clinical ease‐of‐use and reduce the time required for follow‐up procedures of implantable pacemakers for atrial sensing and pacing assessments.