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Updated: Jun 23, 2026
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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
[Atrial sensing with fixed and floating electrodes at identical activities].
D Hartung1, L Thiele, W M Hartung
1Institut für Radiologie, Medizinischen Hochschule Hannover, Hannover, Deutschland.
Herzschrittmachertherapie & Elektrophysiologie
|May 8, 2009
Summary
Floating atrial electrodes significantly reduce intermittent undersensing during activity compared to fixed electrodes. This finding suggests potential benefits for future pacemaker designs, improving atrial signal detection.
Area of Science:
- Cardiology
- Biomedical Engineering
- Electrophysiology
Background:
- Single-lead VDD pacemaker implantation rates are decreasing despite benefits for atrioventricular block.
- Limited data exists comparing atrial sensing performance of floating versus fixed electrodes during identical activities.
Purpose of the Study:
- To compare the atrial sensing performance of floating and fixed electrodes during various standardized activities.
- To analyze beat-to-beat atrial sensing during 24-hour Holter ECG in patients with DDD and VDD systems.
Main Methods:
- Beat-to-beat analysis of 24-hour Holter ECG data.
- Inclusion of 42 patients (22 DDD, 20 VDD systems).
- Standardized activity protocols including supine, side position, seated, hyperventilation, standing, walking, fast walking, and stair climbing.
Main Results:
- Intermittent atrial undersensing occurred in 45% of DDD systems and 20% of VDD systems (p = 0.0024).
- Undersensing was significantly more frequent in the initial 15 seconds of activity (p < 0.001).
- Floating electrodes significantly reduced atrial undersensing frequency in the initial activity phase compared to fixed electrodes (p = 0.0347).
Conclusions:
- Floating atrial electrodes demonstrate superior performance by reducing intermittent undersensing during the onset of activity.
- Earlier atrial signal recognition with floating electrodes offers potential advantages for future pacemaker development.
- Combining VDD floating electrodes with fixed atrial electrodes may enhance DDD pacemaker functionality.
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