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Orthogonal ventricular electrogram sensing.

B N Goldreyer, R Brueske, M B Knudson

    Pacing and Clinical Electrophysiology : PACE
    |July 1, 1983
    PubMed
    Summary

    New pacing lead technology improves ventricular electrogram sensing. Orthogonal electrodes offer better capture verification during cardiac pacing, addressing issues with conventional systems.

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    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.

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