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Electrogram Signals Recorded from Acute and Chronic Pacemaker Implantation Sites in Pacemaker Patients
Author(s) -
THERES HEINZ,
COMBS WILLIAM,
FOTUHI PARWIS,
CONDIE CATHY,
BONDKE HANS JÜRGEN,
STANGL KARL,
BAUMANN CERT
Publication year - 1998
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.1540-8159.1998.tb01056.x
Subject(s) - medicine , amplitude , cardiology , intracardiac injection , sick sinus syndrome , p wave , atrial fibrillation , optics , physics
Electrogram signals recorded from typical pacemaker implantation sites may be useful for a variety of pacemaker system functions including pacemaker follow‐up, atrial and ventricular sensing (event detection), and triggered electrogram storage. We quantified the electrical characteristics of pacemaker pocket electrograms using a subcutaneous electrode array (SEA) in a population of 48 patients undergoing initial or replacement pacemaker implantation. SEA recorded intrinsic R wave amplitudes measured peak to peak averaged 118 μV and 65 μV for the two recorded SEA electrograms and were significantly different (P < 0.001); paced R wave amplitudes averaged 180 μV and 110 μV. P wave amplitudes averaged 39 μV and 26 μV. No statistically significant difference in amplitudes were observed between acute versus chronic pacemaker pocket or indication for pacing (A V block, sick sinus syndrome). Signal to noise ratios, using R wave amplitude as signal, were lower in the SEA electrogram on average (11 dB) compared to the intracardiac electrogram (27 dB), but sufficient for diagnostic assessment. R wave/P wave ratios for SEA signals were lower than surface and intracardiac values 3.1 and 2.7 compared to a range of 6.2–9.8, indicating a relative enhancement of P waves to R waves in SEA signals. In summary, SEA electrograms are of sufficient amplitude and signal quality (signal to noise ratio) to hold promise for future implantable device features such as electrogram telemetry, enhanced sensing, and diagnostic data storage.