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Toward Optimizing a Preshaped Catheter and System Parameters to Achieve Single Lead DDD Pacing
Author(s) -
BROWNLEE ROBERT R.,
SWINDLE M. MICHAEL,
BERTOLET ROY,
NEFF PAUL
Publication year - 1997
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.1540-8159.1997.tb06790.x
Subject(s) - medicine , electrode , catheter , atrium (architecture) , cardiology , lead (geology) , biomedical engineering , atrial fibrillation , amplitude , surgery , optics , chemistry , physics , geomorphology , geology
P wave electrogram amplitudes and atrial stimulation thresholds were determined in eight Hanford miniature swine using a preshaped catheter with an “S” curve in the SVC, and a major lobe in the atrium to enhance electrode contact with the atrial wall. The catheter was designed for pacing and sensing in the DDD mode. P wave amplitudes were also ascertained with two commercially available VDD leads and compared to the data from the experimental catheters. The preshaped catheter used two 6‐mm 2 platinum iridium atrial electrodes with a 7‐mm separation. Both atrial electrodes are on the same side of the catheter, facing outward on the major atrial lobe formed in the catheter. The P wave amplitudes were tested only in the differential bipolar configuration. For the eight preshaped catheters, the mean was 6.6 ± 3.8 mV while for the conventional leads it was 2.9 ± 1.6 mV. The mean atrial stimulation thresholds ranged from 1.1 t 0.2 V to 2.3 ± 1.2 V, with still lower thresholds of 0.9‐1.3 V when using the parallel unipolar atrial electrode configuration, in which both parts of the bipolar atrial electrode are configured as a unipolar electrode. The data suggest that bipolar stimulation may be effective if sequential reverse polarity pulses are used to achieve cathodal stimulation from each electrode of the bipolar pair, on a beat‐to‐beat basis. (PACE 1997; 20[Pt. I]:1354‐1358)