Oversensing of pacemakers in the bipolar pacing configuration: Paradoxic resolution with programming to unipolar sensing

Ben-Zur, Uri; Gross, Jay N.; Goldberger, M.; Tilkemeier, Peter L.; Weyman, Albert K.; Furman, Seymour

doi:10.1016/0002-8703(94)90641-6

Cited by 11 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The possibilities were: (1) Oversensing of P waves itself, (2) Noise generated due to friction between two leads during atrial contraction when there is lead integrity issue. Far-field sensing of the P wave by the ventricular channel with intact ventricular capture, can occur usually with dislodgement of a ventricular lead toward the RV inflow tract or into the coronary sinus [ [2] , [3] , [4] , [5] ]. This could also happen in integrated bipolar ICD leads in a small RV.…”

Section: Commentarymentioning

confidence: 99%

Inhibition of ventricular output in a dual chamber pacemaker with normal pacing and sensing parameters: What is the mechanism?

Bera

Joshi

Majumder

et al. 2022

Indian Pacing and Electrophysiology Journal

View full text Add to dashboard Cite

A 65-year-old gentleman with dual chamber pacemaker presented with presyncope. The ECG raised concerns of oversensing which was confirmed by magnet response. The device interrogation revealed noise in ventricular channel temporally associated with P wave. The pacing thresholds were normal. Although the ventricular lead impedance was within normal limit the impedance trend suggested 100 Ω decline over last 1 year. RV lead insulation failure was speculated and supported by the bipolar and unipolar intracardiac electrogram. Device was programmed to DOO temporarily. He underwent RV lead replacement uneventfully.

show abstract

Section: Commentarymentioning

confidence: 99%

Inhibition of ventricular output in a dual chamber pacemaker with normal pacing and sensing parameters: What is the mechanism?

Bera

Joshi

Majumder

et al. 2022

Indian Pacing and Electrophysiology Journal

View full text Add to dashboard Cite

show abstract

“…Although studies indicate little difference in the sensed signal between unipolar and bipolar lead configurations, on occasion, in the acute setting, unipolarization of a temporary pacing system can be useful. 41 Unipolarization can also be used in permanent pacing systems in some cases of lead insulation break, to reestablish normal pacing and sensing functions, at least temporarily until lead replacement can be carried out.…”

Section: Bradycardiasmentioning

confidence: 99%

Arrhythmias in the Coronary Care Unit

Badhwar

Kusumoto

Goldschlager

2011

J Intensive Care Med

View full text Add to dashboard Cite

Symptomatic sustained cardiac arrhythmias are frequently observed in in the coronary care unit and often lead to hemodynamic compromise, especially in the presence of multisystem disease. The predominant arrhythmias noted in intensive care units are tachyarrhythmias, particularly atrial fibrillation and flutter, and ventricular tachycardia. Bradycardias, arguably less life-threatening than tachyarrhythmias, can arise from sinus node dysfunction or atrioventricular conduction block; transient vagally-mediated bradycardias are frequently encountered as well. Prompt diagnosis of the patient with tachycardia is critical as treatment depends on the accurate diagnosis of tachycardia mechanism. The electrocardiogram remains the most important diagnostic tool for the evaluation of both wide and narrow complex tachycardia. The electrocardiographic diagnosis of wide complex tachycardia is based on evaluation of atrioventricular relationship and QRS morphology while the diagnosis of narrow complex tachycardia is based on the location and morphology of P waves. It is important for critical care specialists to understand the principles of cardiac arrhythmia diagnosis and remain current with the recent advances in the pharmacologic and non-pharmacologic management of patients with arrhythmias.

show abstract

“…The above diagnosis of double counting of the ventricular electrogram requires exclusion of: (1) displacement of the RV lead towards the tricuspid valve with far‐field RV sensing of atrial activity; 16,17 and (2) oversensing of diaphragmatic myopotentials by using testing with deep respiration, coughing, laughing, and the Valsalva maneuver 18–21 …”

Section: Introductionmentioning

confidence: 99%

Double Counting of the Ventricular Electrogram in Biventricular Pacemakers and ICDs

Barold

Herweg

Gallardo

2003

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Oversensing of pacemakers in the bipolar pacing configuration: Paradoxic resolution with programming to unipolar sensing

Cited by 11 publications

References 6 publications

Inhibition of ventricular output in a dual chamber pacemaker with normal pacing and sensing parameters: What is the mechanism?

Inhibition of ventricular output in a dual chamber pacemaker with normal pacing and sensing parameters: What is the mechanism?

Arrhythmias in the Coronary Care Unit

Double Counting of the Ventricular Electrogram in Biventricular Pacemakers and ICDs

Contact Info

Product

Resources

About