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Orthogonal ventricular electrogram sensing
Pacing and Clinical Electrophysiology : PACE
|July 1, 1983
Summary
New pacing lead technology improves ventricular electrogram sensing. Orthogonal electrodes offer better capture verification during cardiac pacing, addressing issues with conventional systems.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Inappropriate demand pacing often stems from inadequate ventricular electrogram sensing.
- Conventional pacing systems struggle to sense electrograms during paced beats due to artifact and repolarization.
- Existing filters and sensitivities enhance sensing of conducted beats but not paced ones.
Purpose of the Study:
- To evaluate a novel pacing lead designed for improved ventricular electrogram sensing.
- To assess the capability of orthogonal electrodes for sensing during both conducted and paced rhythms.
- To determine if the new lead facilitates capture verification in cardiac pacing.
Main Methods:
- A new pacing lead with a tip electrode and three orthogonal sensing electrodes was tested in 22 patients.
- The lead was placed in the right ventricular apex.
- Orthogonal and unipolar tip electrograms were compared during conducted rhythms and paced beats.
Main Results:
- Orthogonal electrograms showed favorable comparison with tip electrograms during conducted beats.
- During pacing, orthogonal electrograms successfully detected stimuli and ventricular electrograms, unlike tip electrograms.
- The new lead demonstrated a sensing capability for capture verification during pacing.
Conclusions:
- The novel pacing lead offers improved ventricular electrogram sensing compared to conventional systems.
- Orthogonal electrodes provide a redundant sensing capability and enable capture verification.
- This technology addresses limitations in current cardiac pacing systems.