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The ventricular endocardial paced evoked response.

R M Donaldson, A F Rickards

    Pacing and Clinical Electrophysiology : PACE
    |March 1, 1983
    PubMed
    Summary
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    This study shows that pacing-evoked T wave recordings accurately assess myocardial repolarization. This technique enables a new pacing system for physiological rate control using standard electrodes.

    Area of Science:

    • Cardiac Electrophysiology
    • Cardiovascular Device Technology

    Background:

    • The endocardial ventricular evoked response (VER) is uniform but longer at the heart's base than apex.
    • A single lead for pacing and sensing allows recording the T wave, reflecting local repolarization after pacing-induced depolarization.

    Purpose of the Study:

    • To evaluate the pacing-evoked T wave as a method for assessing myocardial repolarization.
    • To introduce a novel pacing system design utilizing stimulus-to-evoked T wave timing for physiological rate control.

    Main Methods:

    • Recording the ventricular evoked response and T wave using a unipolar stimulus via an endocardial lead.
    • Comparing pacing-evoked response studies with monophasic action potential recordings after Class 3 drug administration.

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    Main Results:

    • Pacing-evoked T wave recordings correlate with monophasic action potential recordings, validating repolarization assessment.
    • Stimulus-to-evoked T wave timing facilitates a new pacing system design.

    Conclusions:

    • Myocardial repolarization can be accurately assessed using pacing-evoked T wave recordings.
    • A novel pacing system offers physiological rate control, independent of atrial activity, using conventional leads.