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Evaluation of the Atrial Evoked Response for Capture Detection with High‐Polarization Leads
Author(s) -
SPERZEL JOHANNES,
BINNER LUDWIG,
BORIANI GIUSEPPE,
BIFFI MAURO,
SNELL JEFF,
SCHEINER JÖRG,
PARK EULJOON,
BORNZIN GENE
Publication year - 2005
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.1540-8159.2005.00059.x
Subject(s) - medicine , polarization (electrochemistry) , cardiology , stimulus (psychology) , intracardiac injection , chemistry , psychology , psychotherapist
AutoCapture™ based on the evoked response can be confounded by electrode polarization. In this study, polarization was measured in human subjects who had chronic atrial leads. The aim of the study was to determine whether electrode polarization can be measured using a time integral atrial evoked‐response integral (AERI) of the negative portion of the atrial paced ER evoked‐response signal and to determine whether high‐polarization atrial leads unsuitable for AutoCapture™ can be identified a priori. Atrial intracardiac‐electrogram (IEGM) signals from 39 patients with implanted pacemakers were recorded and analyzed. The signals were recorded during conventional atrial‐threshold searches. A total of 221 atrial‐capture thresholds were recorded, ranging from 0.25 to 2.75 V with a mean of 0.79 V. Each evoked response was evaluated using the AERI in a 36 ms window following the 0.4 ms atrial stimulus. The polarization was estimated as a linear function of stimulus voltage using the evoked‐response signal integral of captured beats identified on the IEGM. The 221 threshold‐search datasets were obtained using leads with eight different electrode materials. Polarization could be measured using AERI as a function of stimulus voltage. Furthermore, this polarization measure can be used to identify high‐polarization leads, which are ill suited for the atrial AutoCapture™ algorithm.