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Europace 2005 7(1):67-72; doi:10.1016/j.eupc.2004.11.002
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

Rejection of atrial sensing artifacts by a pacing lead with short tip-to-ring spacing

A. Nasha,*, G. Fröhligb, M. Taborskyc, E. Stammwitzd, F. Marue, L.H.M. Bouwensf and C. Çelikerg

aDepartment of Cardiology, The Southwest Cardiothoracic Centre, Derriford Hospital Plymouth PL6 8DH, UK; bUniversitätskliniken des Saarlandes Homburg/Saar, Germany; cNemocnice Na Homolce Prague, Czech Republic; dKreiskrankenhaus Kardiologie Leer, Germany; eDanderyds Sjukhus Medicinkliniken Danderyd, Sweden; fDeventer Ziekenhuis Deventer, The Netherlands; gInstitute of Cardiology of University of Istanbul Istanbul, Turkey

AIMS: The ability of a new pacing lead design, with a 10 mm tip-to-ring spacing, to facilitate rejection of sensed far field R-waves and myopotentials was evaluated.

METHODS AND RESULTS: Measurements were performed in 66 patients. The occurrence of far field R-wave sensing and myopotential sensing was determined by means of the surface ECG and the ECG markers provided by the pacemaker. At an atrial sensitivity of 0.25 mV and an atrial blanking of 50 ms far field R-wave sensing was observed in 12 patients (18.2%) and at an atrial sensitivity of 1.0 mV no far-field R-wave sensing was observed. Myopotentials were sensed in 3 patients. In all patients the measured P-wave amplitude was at least twice the estimated amplitude of the far field R-wave at an atrial blanking of 50 ms.

CONCLUSION: The results from this study show that a small tip-to-ring spacing allows for programming of a high atrial sensitivity and short atrial blanking with an acceptably low risk for atrial artifact sensing.

Key Words: myopotentials, far field R-wave sensing, atrial leads, tip-to-ring spacing

*Corresponding author. Tel.: +44 1752 792 661; fax: +44 1752 763 078. E-mail address: tony{at}cammedcentre.demon.co.uk (A. Nash).


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