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Europace Advance Access originally published online on April 10, 2009
Europace 2009 11(5):618-624; doi:10.1093/europace/eup078
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Leads and Lead Extraction

Multicenter clinical experience with an atrial lead designed to minimize far-field R-wave sensing

Jeffrey W.H. Fung1,*, Johannes Sperzel2, Cheuk Man Yu1, Joseph Y.S. Chan1, Robert N. Gelder3, Michael X. Yang4, Ryan Rooke4, Peter Boileau4 and Gerd Fröhlig5

1 Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China; 2 Kerckhoff Klinik GmbH, Bad Nauheim, Germany; 3 Monash Medical Center, Melbourne, Australia; 4 St Jude Medical, Sylmar, CA, USA; 5 Universitätskliniken des Saarlandes, Homburg/Saarland, Germany

Aims: To evaluate a novel atrial lead designed to reduce far-field sensing.

Methods and results: Sixty-three patients with standard pacing indications were randomized to receive an OptiSenseTM 1699T (St Jude Medical, USA) or conventional pacing lead in the right atrium. Post-implant follow-up was conducted for all patients at 90 days and for a subset at 360 days. Standard electrical parameters were measured. Thresholds of sensing were determined for far-field ventricular signals. The number of inappropriate mode switches was determined from the stored intracardiac electrogram (IEGM). At 90 days, an IEGM Holter recorded 24 h of IEGM. With atrial sensitivity programmed at 0.3 mV, no far-field sensing occurred in the OptiSenseTM group, but it did occur in 20% and 30% of the control group at 90 and 360 days, respectively. Inappropriate mode switching was observed in 4% of the OptiSenseTM group in contrast to 23% of the control group. The IEGM Holter found no far-field sensing in the OptiSenseTM group, but did find 83 023 far-field events from 22% of control patients. The standard electrical parameters of the OptiSenseTM leads were acceptable.

Conclusion: The OptiSenseTM lead reduced ventricular far-field sensing in the atrium while maintaining satisfactory pacing and sensing performance, resulting in less inappropriate mode switch.

Key Words: Far-field sensing, Atrial lead, Pacing, Automatic mode switching, Atrial fibrillation

* Corresponding author. Tel: +86 852 2683 8525, Fax: +86 852 2683 8534, Email: jwhfung{at}cuhk.edu.hk

Manuscript submitted 19 January 2009. Accepted after revision 11 March 2009.


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