© 2002 by European Society of Cardiology
CASE REPORTS
Incessant atrioventricular dissociation due to far-field QRS oversensing and recurrent mode switch in a dual chamber pacemaker
Division of Cardiology, University Hospital Lausanne, Switzerland
We report the case of a repetitive and incessant activation of mode switch in a dual chamber pacemaker because of the inappropriate sensing by the atrial lead of far-fields signals from the ventricular evoked response. The incidence, consequences and prevention of the oversensing of far-field QRS complexes are discussed. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.
Key Words: Far-field QRS signal, mode switching, atrial oversensing, cross-talk
Correspondence: J. Schlaepfer, MD, Division de Cardiologie, Centre Hospitalier Vaudois Rue du Bugnon 19, 1011 Lausanne, Switzerland. E-mail: jurg.schlaepfer{at}chuv.hospvd.ch
[1] Lemke B. Problems of ‘automatic mode switching’. Herzschr Electrophys 1999; 10: I/1–I/3.
[2] Israel CW and Lawo T. Use of an advanced mode switching algorithm in Inos2 CLS and Logos dual chamber pacemakers. Herzschr Electrophys 1999; 10: I/72–I/80.[CrossRef]
[3] Shandling AH, Castellanet MJ, Messenger JC, Brownlee RR. Utility of the atrial endocardial electrogram concurrent with dual-chamber pacing in the determination of a pacemaker-mediated arrhythmia. Pacing Clin Electrophysiol 1988; 11: 1419–1425.[Medline]
[4] Johnson CD. Atrial synchronous ventricular inhibited (VDD) pacemaker mediated arrhythmia due to atrial undersensing and atrial lead oversensing of far-field ventricular afterpotentials or paced beats: crosstalk. Pacing Clin Electrophysiol 1986; 9: 710–719.[Medline]
[5] Sermasi S and Marconi M. VDD single-pass lead pacing: sustained pacemaker-mediated tachycardias unrelated to retrograde conduction. Pacing Clin Electrophysiol 1992; 15: 1903–1907.[Medline]
[6] Brandt J and Worzewski W. Far-field QRS complex sensing: prevalence and timing with bipolar atrial leads. Pacing Clin Electrophysiol 2000; 23: 315–320.[Medline]
[7] Brandt J, Fåhraeus T, Schüller H. Far-field QRS complex sensing via the atrial pacemaker lead. I. Mechanism, consequences, differential diagnosis and countermeasures in AAI and VDD/DDD pacing. Pacing Clin Electrophysiol 1988; 11: 1432–1438.[Medline]
[8] Frohlig G, Helwani Z, Kusch O, Berge M, Schieffer H. Bipolar ventricular far-field signals in the atrium. Pacing Clin Electrophysiol 1999; 22: 1604–1613.[Medline]
[9] Brouwer J, Nagelkerke D, den Heijer P, et al. Analysis of atrial sensed far-field ventricular signals: a reassessment. Pacing Clin Electrophysiol 1997; 20: 916–922.[CrossRef][Medline]
[10] Brandt J, Fåhraeus T, Schüller H. Far-field QRS complex sensing via the atrial pacemaker lead. II. Prevalence, clinical significance and possibility of intraoperative prediction in DDD pacing. Pacing Clin Electrophysiol 1988; 11: 1540–1544.[Medline]
[11] Fitts SM, Hill MRS, Mehra R, Gillis AM. Pacing Clin Electrophysiol 2000; 23: 1080–1086.[CrossRef][Medline]
[12] Nowak B, Middeldorf T, Voigtländer T, et al. How reliable is atrial sensing in single lead VDD pacing. Pacing Clin Electrophysiol 1998; 21: 2226–2231.[Medline]
[13] Wolpert C, Jung W, Scholl C, Spehl S, Cyran J, Lüderitz B. Electrical proarrhythmia: induction of inappropriate atrial therapies due to far-field R wave oversensing in a new dual chamber defibrillator. J Cardiovasc Electrophysiol 1998; 9: 859–863.[Web of Science][Medline]
[14] Timmis GC, Westveer DC, Gadowsli G, et al. The effect of electrode position on atrial sensing for physiologically responsive cardiac pacemakers. Am Heart J 1984; 108: 909–916.[CrossRef][Web of Science][Medline]
[15] Theres H, Sun W, Combs W, et al. P wave and far-field R wave detection in pacemaker patient atrial electrogram. Pacing Clin Electrophysiol 2000; 23: 434–440.[Medline]
[16] De Boer H, Kofflard M, Scholtens T, et al. Differential bipolar sensing of a dual chamber pacemaker. Pacing Clin Electrophysiol 1988; 11: 158–165.[Medline]
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. W.H. Fung, J. Sperzel, C. M. Yu, J. Y.S. Chan, R. N. Gelder, M. X. Yang, R. Rooke, P. Boileau, and G. Frohlig Multicenter clinical experience with an atrial lead designed to minimize far-field R-wave sensing Europace, May 1, 2009; 11(5): 618 - 624. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Lewicka-Nowak, A. Kutarski, A. Dabrowska-Kugacka, P. Rucinski, P. Zagozdzon, and G. Raczak Atrial lead location at the Bachmann's bundle region results in a low incidence of far field R-wave sensing Europace, February 1, 2008; 10(2): 138 - 146. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Nash, G. Fröhlig, M. Taborsky, E. Stammwitz, F. Maru, L.H.M. Bouwens, and C. Çeliker Rejection of atrial sensing artifacts by a pacing lead with short tip-to-ring spacing Europace, January 1, 2005; 7(1): 67 - 72. [Abstract] [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||