Stimulation and sensing thresholds for cardiac pacing: Electrophysiologic and technical aspects

Barold, S. Serge; Ong, Ling S.; Heinle, Robert A.

doi:10.1016/0033-0620(81)90025-6

Cited by 67 publications

(8 citation statements)

References 37 publications

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“…Smaller endocardial pacing poles have been shown to create a smaller but more intense electrical field and this property is likely to apply to esophageal pacing poles as well. 10,17 The results of this study cannot be used to effectively discriminate between the individual importance of polar surface area and catheter shape. As such, further investigation is necessary in order to fully understand what effects polar surface and catheter shape may have on the efficacy of TAP.…”

Section: Discussionmentioning

confidence: 86%

Efficacy of two commercially available cardiac pacing catheters for transesophageal atrial pacing in dogs

Chapel

Sanders

2012

Journal of Veterinary Cardiology

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Objective Compare the efficacy of two cardiac pacing catheters for transesophageal atrial pacing (TAP). Animals Ten healthy dogs. Methods Transesophageal atrial pacing was attempted in left lateral recumbency under general anesthesia. In series, a curved electrophysiologic (EP) catheter and a straight transesophageal pacing (TP) catheter were passed transorally into the distal esophagus, caudal to the heart. Each catheter was slowly withdrawn until pacing was initiated. The catheter continued to be withdrawn in 5 mm increments until capture was no longer achieved at maximal pacing setting creating a total zone of capture (tZOC). Minimum pacing threshold (Thmin) and degree of extraneous muscle stimulation (EMS) were determined at each site. Results The EP catheter achieved TAP in 10/10 dogs with a Thmin of 8.8 ± 4.8 mA and tZOC of 4.0 ± 1.7 cm. The TP catheter achieved TAP in 7/10 dogs with a Thmin of 22.5 ± 5.6 mA and tZOC of 1.2 ± 1.6 cm. No EMS was noted during TAP at Thmin using the EP catheter. Of the 7 dogs in which TAP was successful, 3/7 experienced considerable EMS at Thmin. There was no significant relationship between patient body weight and Thmin with either catheter (EP catheter P= 0.09; TP catheter P= 0.81) Conclusions The electrophysiology catheter captured the atria of more dogs over a larger area without EMS as compared to the TP catheter. The electrophysiology catheter is recommended for transesophageal atrial pacing in dogs.

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Section: Discussionmentioning

confidence: 86%

Efficacy of two commercially available cardiac pacing catheters for transesophageal atrial pacing in dogs

Chapel

Sanders

2012

Journal of Veterinary Cardiology

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“…10,11 Note that in order to obtain optimal results, each pacemaker manufacturer supplies PSAs with band-pass filters that match the filters used in their pacemaker systems. 1 PSA cable connections (Medtronic model 5833SL of 3.66 m length and St. Jude Medical model 4051 L of 3.7 m length, respectively) were used to display the EGM through the implanted RV lead in bipolar mode by using crocodile clips on the lead terminal pins. Sensing measurements were taken through PSA after helix extension of the active fixation RV lead.…”

Section: Implantation Proceduresmentioning

confidence: 99%

“…(PSA) unit. 1 The PSA application displays real-time signals for surface electrocardiogram (ECG), generates sensing markers for local EGM, and outputs those signals to a recorder as well. Following implantation, the implanted pulse generator is expected to replicate the sensing data obtained during the PSA operation.…”

mentioning

confidence: 99%

Right ventricular lead sensing latency in pacemaker therapy

Zagkli

Kalovrenti

Patrinos

et al. 2022

Journal of Arrhythmia

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Background Pacemaker implantation involves intraoperative testing of ventricular sensing using a device called a pacing system analyzer (PSA). The value obtained is expected to correspond to those taken by the pacemaker after its implantation. This study determined the latency period for sensing intracardiac electrogram (EGM) by the right ventricular (RV) lead. Methods Patients without significant heart disease and underlying intrinsic atrioventricular (AV) conduction underwent Medtronic or Abbott dual‐chamber pacemaker implantation with the RV lead positioned on the mid‐septum. Real‐time sensing data were obtained through PSA and after pacemaker implantation to evaluate latency as the time interval Q‐VS between the onset of QRS on surface electrocardiogram and the sensed EGM by the RV lead. Results Of 157 patients, 105 had narrow QRS (<120 ms) and 52 had wide QRS of complete right bundle branch block (RBBB). Both narrow‐QRS and RBBB patients had longer sensing latency through PSA (50.9 ± 24.2 and 67.8 ± 32.9 ms, respectively) than through pacemaker (18.2 ± 12.8 and 31.2 ± 14.8 ms, respectively, both p < 0.001). RBBB patients had longer sensing latency compared with narrow QRS patients, either through PSA or through pacemaker (p < 0.001). The sensing latency of Medtronic recipients was longer than those of Abbott in narrow‐QRS (p < 0.05), but not in RBBB. Conclusion We demonstrated longer RV lead sensing latency (1) through PSA than through pacemaker, (2) in RBBB than in narrow‐QRS, and (3) in Medtronic pacemakers compared with Abbott pacemakers. Knowledge of sensing latency helps the optimization of the AV delay.

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“…Sensing in pacemaker therapy means the ability of the device to recognize the heart’s intrinsic signal through the implanted lead by analyzing the local endocardial electrogram (EGM) with specific reference to the QRS on the surface electrocardiogram (ECG). 1 Knowledge of the time course of the propagation of right ventricular (RV) electrical activation during intrinsic conduction is of great value for the understanding of ventricular sensing. With endocardial electrode catheters, early studies have demonstrated significant differences in the time of ventricular activation at the different RV anatomical locations, including early septal excitation starting at the left ventricular side and spreading to the right, activation of the RV apex before the RV outflow tract, and delayed RV activation in the presence of complete right bundle branch block (RBBB).…”

Section: Introductionmentioning

confidence: 99%

Differences in Electrical Delay Between the Mid-septum and Apex with the Right Ventricular Lead: Novel Implications for Pacemaker Sensing

Zagkli¹,

Trigka²,

Koros³

et al. 2023

J Innov Cardiac Rhythm Manage.

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Stimulation and sensing thresholds for cardiac pacing: Electrophysiologic and technical aspects

Cited by 67 publications

References 37 publications

Efficacy of two commercially available cardiac pacing catheters for transesophageal atrial pacing in dogs

Efficacy of two commercially available cardiac pacing catheters for transesophageal atrial pacing in dogs

Right ventricular lead sensing latency in pacemaker therapy

Differences in Electrical Delay Between the Mid-septum and Apex with the Right Ventricular Lead: Novel Implications for Pacemaker Sensing

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