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Implant and Long‐Term Evaluation of Atrial Signal Amplification in a Single‐Lead ICD
Author(s) -
STAZI FILIPPO,
MAMPIERI MASSIMO,
CARDINALE MARIO,
LAUDADIO M. TERESA,
GARGARO ALESSIO,
DEL GIUDICE GIOVANNI BATTISTA
Publication year - 2012
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.1540-8159.2012.03452.x
Subject(s) - medicine , implant , atrial fibrillation , lead (geology) , cardiology , sinus rhythm , implantable cardioverter defibrillator , p wave , single center , surgery , geomorphology , geology
Background: In patients without clinical indications for pacing the use of a single‐lead implantable cardioverter defibrillator (ICD) implementing atrial sensing capability with proper signal amplification management may represent a useful therapeutic option, combining the positive features of both single and dual‐chamber devices. The aim of the study was to evaluate the atrial signal amplification and its long‐term stability in a single‐lead ICD system adding atrial sensing to a standard single‐chamber ICD.Methods: P‐wave amplitudes were collected and compared at implant both with a conventional external device (“unfiltered” P wave) and telemetrically with the implanted ICD (“filtered” P wave). Filtered/unfiltered P‐wave ratio (amplification factor, AmF) was evaluated at implant and during follow‐up.Results: In 43 enrolled patients (38 men, age 64 ± 16 years), the mean filtered P wave at implant was significantly higher than the unfiltered P wave (3.85 ± 0.81 mV vs 2.0 ± 1.49 mV; P < 10 −11 ), with a mean AmF value of 2.77 ± 1.62. In seven patients with atrial fibrillation at implant, the AmF was higher (4.62 ± 1.94) than in patients in sinus rhythm (2.41 ± 1.30; P < 0.001). A significant linear correlation was found between the inverse of P wave and the AmF (R = 0.82, P < 0.00001). In 25 patients followed for 384 ± 244 days, atrial undersensing was never documented and AmF did not change from implant (3.19 ± 1.82; P = 0.24), also in different body position and breathing conditions.Conclusions: The single‐lead ICD system evaluated reliably amplified P‐wave amplitudes by a factor of about three, maintaining this performance during the observed follow‐up. (PACE 2012; 35:1119–1125)