© 2004 by European Society of Cardiology
Reduction of the pace polarization artefact for capture detection applications by a tri-phasic stimulation pulse
aDepartment of Cardiology, Royal Brompton Hospital Sydney Street, London SW3 6NP, UK; bAbteilung Kardiologie, Innere Medizin 3, Universitätskliniken des Saarlandes Homburg, Germany; cAfdeling Cardiologie, St. Lucas Andreas Ziekenhuis Amsterdam, The Netherlands; dHeilig Hart Ziekenhuis Roeselaere, Belgium; eUniversitätsklinik Innsbruck, Austria; fDepartment of Cardiothoracic Surgery, Sahlgrenska Hospital Göteborg, Sweden; gService Cardiologie, C.H.R.U. Cote de Nacre Caen, France; hAbteilung Kardiologie, Universitätsklinikum Otto von Guericke Magdeburg, Germany; iKreiskrankenhaus Leer, Germany; jVitatron B.V. Arnhem, The Netherlands
This study investigated the ability to minimize pace polarization artefacts (PPA) by adjusting the post-stimulus pulse duration of a tri-phasic stimulation pulse. Adjustment of the stimulation pulse was enabled by downloading special study software into an already implanted pacemaker. Tests were performed in a total of 296 atrial leads and 311 ventricular leads. Both chronic and acute leads were included in the study. Statistically significant differences were found in the initial PPA (without any adjustment of the stimulus pulse) between atrial and ventricular leads. In addition, significant differences were observed among various lead models with respect to changes over time in the initial ventricular PPA. Successful PPA reduction was defined as a reduction of the PPA below 0.5 mV for atrial leads and below 1 mV for ventricular leads. Results show a success rate for ventricular and atrial PPA reduction of 97.8% and 98.7%, respectively. Threshold tests showed that after reduction of the PPA loss of ventricular capture can be reliably detected. However, atrial threshold tests showed many false positive evoked response detections. In addition, unexpectedly high evoked response amplitudes were observed in the atrium after reduction of the PPA. Results from additional measurements suggest that these high atrial evoked response amplitudes come from the influence of the input filter of the pacemaker.
Key Words: capture detection, polarization, evoked response, pacing threshold
*Corresponding author. Tel.: +44 20 7351 8607; fax: +44 20 7351 8625. E-mail address: europace.office{at}virgin.net (R. Sutton).
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  W. G. de Voogt, B. F. M. Vonk, B. A. Albers, and F. Hintringer Understanding capture detection Europace, January 1, 2004; 6(6): 561 - 569. [Abstract] [Full Text] [PDF]
|
|