|
Single
Lead Atrial Synchronous Ventricular |
A.
Tedeev, G. Katsitadze, D. Bregvadze
|
|
The
purpose of this research was to study the effect and clinical reliability
of electrostimulation of the heart in the VDD mode using a "SINGLE
LEAD" electrode. The following particular aspects of the VDD mode
pacing were analysed: 1) reliability of the P wave detection with
different positions of the body, with normal and deep breathing and under
load; 2) suppresion of such interferences as muscular potencials,
electrostimulation of increased energy, remote ventricular potencial.
Within the period of 1998 - 2003 years VDD systems were implanted in 52
cases ( 33 males and 19 females; age range 27 to 75; mean age 67,8 years )
in our clinic. The indications consisted in a high degree AV block at a
normal functioning of the sinus node. The retrograde VA conduction was not
regarded as a counterindication owing to the durable algorithm operating
in the pacemakers to provide protection against pacemaker - related
tachycardia. Frequent and sustained episodes of atrial flutter or
fibrillation were regarded as a counterindication. In the postoperative
observations the amplitudes of the P wave measured at different positions
of the body and with normal and deep breathing served as reliability
criteria of the atrial detection. In addiction, a 24 - hour ECG monitoring
and stress tests were carried out.According to the telemetrically obtained
intracardial electrograms minimal amplitudes of the P wave were in the
detection area of the VDD - mode pacemaker. The obtained 24 - hour ECG
record and the AV synchronization expressed in percent made up 99,95 % ±
0,19 %. Not a single case of atrial sensing of muscular potencials or
interferences during high power electrostimulation was observed.
Electrostimulation of the heart in the VDD mode using "SINGLE
LEAD" electrodes and special pacemakers for the VDD - mode cardiac
pacing ensures a reliable detection of the P wave, which eventually
enables correct AV synchronous pacing. With this in view, treatment of
cases with a high degree of the AV block and a normal functioning of the
sinus node during the VDD - mode cardiac pacing using a "SINGLE
LEAD" electrode can be regarded as an alternative of standart two -
chamber systems. |
|
Literature: 1.
Sutton R.//"The second coming of VDD"//EUR.J.C.P.//1992//4//225
- 226. 2.
Antonioli G.E.//"Single lead atrial synchronous ventricular
pacing. A dream come tru".//PACE//1994//17//1531
- 1547. 3.
Nathan D. A., Center S., Wu C. Y., Keller W.//"An implantable
synchronous pacemaker for the long - term correction of complete heart
block"//Am. J. Cardiol//1963//11//362 - 367. 4.
Kruse I., Ryden L., Duffin E.//"Clinical evaluation of atrial
synchronous ventricular inhibited pacemakers"//PACE//1980//3//641 -
650. 5.
Crick J. C.//"European multicenter prospective follow - up
study of 1002 implants of single lead VDD pacing
system"//PACE//1991//14//1742
- 1744.
|