Detection of Ventricular Fibrillation by Transvenous Defibrillating Leads:

Goldberger, Jeffrey J.; Horvath, George; Donovan, Doris; Johnson, David A.; Challapalli, Ram; Kadish, Alan H.

doi:10.1111/j.1540-8167.1998.tb00954.x

Cited by 24 publications

(11 citation statements)

References 10 publications

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“…Our results are consistent with past investigations. An older study 11 did not find significant differences between the sensed bipolar and integrated bipolar electrograms with an earlier type of lead.…”

Section: Discussionmentioning

confidence: 69%

True Bipolar and Integrated Bipolar Sensing and Detection by Implantable Defibrillators

Verga

Gillberg

Greenberg

et al. 2011

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 69%

True Bipolar and Integrated Bipolar Sensing and Detection by Implantable Defibrillators

Verga

Gillberg

Greenberg

et al. 2011

Pacing Clinical Electrophis

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“…Differences in the sensing performance of true and integrated bipolar leads have been reported in the literature [4] [5] [6] [13]. The cause of this discrepancy has not been clearly elucidated.…”

Section: Discussionmentioning

confidence: 93%

“…In redetection, for example, it has been postulated that the more likely explanation is myocardial stunning occurring with an integrated bipolar configuration [5]. On the other hand, some authors concentrate on the measurement properties of the lead system, and argue that the quality of the signals recorded by true and integrated bipolar configurations is different [4] [6] [13].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the scope of true and integrated bipolar leads in implantable cardioverter defibrillators

Requena‐Carrión

Väisänen²,

Alonso‐Atienza

et al. 2007

2007 Computers in Cardiology

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Lead design is a critical factor for detecting and redetecting lethal arrhythmias in electrograms (EGM) from Implantable Cardioverter Defibrillators (ICD). The estimation of the scope of a lead can help to elucidate the anatomical origin of recorded EGM and explain signal features. In this paper, we compare quantitatively the scope of true and integrated bipolar sensing leads by combining bioelectric signal modeling and numerical analysis. We define the scope in terms of the Mean Square Difference (MSD) between the EGM generated by the whole ventricular myocardium and the EGM generated by smaller regions within the ventricular myocardium. Results show that integrated bipolar leads have a wider scope than true bipolar leads, although narrower than unipolar leads. Further, the extent of myocardium within the scope is distributed for integrated bipolar leads along the septum and anteriorly, while for true bipolar leads is located close to the electrode site.

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“…Some authors concentrate on the measurement properties of the lead system and argue that the quality of the signals recorded by dedicated and integrated bipolar configurations is different. [12][13][14] Requena-Carrión et al 15 reported that EGM features can be explained by estimating the extent of myocardium within the range of the lead. They investigated differences in the sensing range of true and integrated bipolar leads by means of bioelectric signal modeling and numeric methods reporting that dedicated bipolar leads have a narrower antenna/sensing field/range than integrated bipolar leads.…”

Section: Discussionmentioning

confidence: 99%

T-Wave Oversensing in Patients With Brugada Syndrome: True Bipolar Versus Integrated Bipolar Implantable Cardioverter Defibrillator Leads

Rodríguez‐Mañero

Asmundis

Sacher

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Background-It is thought that dedicated bipolar are more susceptible to T-wave oversensing when compared with integrated bipolar leads. This could be of extreme importance in patients with Brugada syndrome (BrS) because T-wave oversensing in this population is more frequent when compared with other implantable cardioverter defibrillator (ICD) recipients without BrS. We aimed to compare the incidence of T-wave oversensing in patients with BrS according to the type of lead (integrated bipolar versus true/dedicated bipolar). Methods and Results-All patients diagnosed with BrS with an ICD implant in 10 tertiary hospitals between 1993 and 2013were included in the study. A total of 480 patients were included (mean age, 45.6±14 years). During a mean follow-up of 74.9±51.7 months (median, 69; range, 2-236), 28 patients had T-wave oversensing (5.8%), leading to inappropriate shock in 18 (3.8%). All these events occurred in patients with true bipolar ICD leads (P=0.01) and in 2 patients it was solved instantaneously by changing the configuration from a dedicated to an integrated bipolar sensing configuration. In the stepwise multivariate models, only integrated bipolar ICD leads (hazard ratio, 0.34; 95% confidence interval, 0.171-0.675; P=0.002) was independent predictor of non-T-wave oversensing. Conclusions-T-wave oversensing is a potential reason of inappropriate shocks in patients with BrS receiving ICDs. In the vast majority it can be solved by reprogramming. However, in some patients it still requires invasive intervention. Importantly, incidence is significantly lower using an integrated bipolar lead system when compared with a dedicated bipolar lead system and hence the latter should be routinely used in BrS cases. Rodríguez-Mañero et al T-Wave Oversensing in Brugada Syndrome 793oversensing when compared with integrated bipolar leads, probably because of greater variations in R-wave amplitude. 3,4 This could be of extreme importance in BrS because T-wave oversensing in this population has been reported to be more frequent. 5We aimed to compare the incidence of T-wave oversensing in patients with BrS according to the type of ICD lead (integrated bipolar [coil plus distal lead electrode] versus dedicated bipolar). MethodsAll patients diagnosed with BrS and implanted with an ICD in 10 tertiary hospitals between 1993 and 2013 were included in the study. The diagnosis was made after an episode of aborted sudden cardiac arrest, during evaluation of syncope, in asymptomatic patients with a suggestive ECG pattern recorded during routine examination, or as a consequence of familial screening after the diagnosis of BrS in a family member. This registry was approved by the institutional review committee, and the subjects gave informed consent.Patients were included in the study if they had a type 1 Brugada pattern on ECG at baseline on at least 1 occasion or after provocation with a class I antiarrhythmic drug (determined by its availability in the participating hospitals; ajmaline, pilsicainide, flecainide, or procainamida...

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Detection of Ventricular Fibrillation by Transvenous Defibrillating Leads:

Cited by 24 publications

References 10 publications

True Bipolar and Integrated Bipolar Sensing and Detection by Implantable Defibrillators

True Bipolar and Integrated Bipolar Sensing and Detection by Implantable Defibrillators

Comparison of the scope of true and integrated bipolar leads in implantable cardioverter defibrillators

T-Wave Oversensing in Patients With Brugada Syndrome: True Bipolar Versus Integrated Bipolar Implantable Cardioverter Defibrillator Leads

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