Improved Technique in Permanent Atrial Pacing

Summary

At the present time, the relatively high atrial Stimulation threshöld and the low and often unstable P wave amplitude are the main concerns in atrial pacing. As a further contribution to the Solution of this problem we used a screw-in atrial lead in 16 patients.

During the implantation, atrial mapping was performed in order to establish the position with the best electrical performance. The acute threshold for voltage at a pulse duration of 1 ms averaged 0.49 ± 0.18 Volt. The acute peak-topeak P wave amplitude averaged 4.6 mV ± 1.3. No complication occurred at the time of the implantation. Follow-up periods averaged 12 months.

No dislocation or bleeding was observed during a followup period of up to 28 months.

Using this lead together with intraoperative atrial mapping, it is possible to achieve an acute strength-duration relationship in the atrium at a level similar to that in the ventricle. The results of this study demonstrate that intraoperative mapping is an important step in enhancing the safety margins and long-term Performance of atrial pacing.

Key words

Atrial pacing - Atrial electrode - Screw-in-electrode - Sick-sinus Syndrome - Endocardial mapping