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Related Experiment Videos

["QT" pacemaker in aggregate exchange. Do old electrodes impair functional ability?].

M Sigmund1, P Schwindke, S Recker

  • 1Medizinische Klinik I, RWTH Aachen.

Zeitschrift Fur Kardiologie
|March 1, 1991
PubMed
Summary
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QT-interval driven pacemakers offer reliable T-wave sensing for rate responsiveness. Lower output voltages (2.5V) ensure consistent detection, crucial for pacemaker replacement procedures.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Pacemaker replacement offers an opportunity to evaluate chronic lead performance.
  • QT-interval driven pacemakers provide rate responsiveness based on ventricular repolarization.
  • Assessing T-wave sensing is critical for the proper functioning of these pacemakers.

Purpose of the Study:

  • To evaluate the electrophysiological properties and limitations of chronic pacemaker leads.
  • To assess T-wave detectability with different pacemaker systems and output settings.
  • To determine the reliability of T-wave sensing during pacemaker replacement.

Main Methods:

  • Recorded intracardiac electrograms via chronic leads in 30 patients undergoing pacemaker replacement.

Related Experiment Videos

  • Evaluated T-wave detectability using varying pulse amplitudes (2.5V and 5.0V) and two pacemaker systems (TX 915, Rhythmyx).
  • Analyzed T-wave signal characteristics, including capacitor discharge effects and amplitude, across different devices and settings.
  • Main Results:

    • At 2.5V output, T-wave amplitude was ≥1.5 mV in all 19 patients paced at this voltage.
    • At 5V output, 9/30 patients had T-wave amplitude <1 mV, with 6/30 experiencing undetectable T-waves.
    • The Rhythmyx pacemaker demonstrated markedly better T-wave discrimination compared to the TX 915.
    • Reliable T-wave sensing was achieved at 2.5V/0.2ms in 37 patients, while 5V/2ms failed in 8/37 cases.

    Conclusions:

    • QT-interval driven pacemakers can be implanted during replacement if stimulation at <2.5V is sufficient.
    • Chronic lead performance, particularly T-wave sensing, is voltage-dependent.
    • Newer pacemaker systems like Rhythmyx show improved T-wave discrimination, enhancing reliability.