Stability of far field R wave signals in different conditions

Cools, F.; Twembeke, R. R. C. van; Backers, Jos; Verpooten, Gert A.

doi:10.1053/eupc.2002.0299

Cited by 14 publications

(21 citation statements)

References 17 publications

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“…However, Cools et al found that supine measurements were generally sufficient to predict the presence vs. absence of FFRW sensing at rest or at peak exercise. 10 Third, the prevalence and characteristics of FFRW were studied 7 days after pacemaker implantation and we did not examine the long-term evolution of the amplitude of sensed FFRW. However, in the study by Fung et al, the amplitude of FFRW at 90 days and at 1 year of follow-up was similar.…”

Section: Clinical Implications and Study Limitationsmentioning

confidence: 99%

Incidence and Characteristics of Far-Field R-Wave Sensing in Low Right Atrial Septum Pacing

Minamiguchi

Abe

Kohno

et al. 2012

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp acemaker diagnostics have become an important means of detecting and monitoring atrial tachyarrhythmias (ATA) in recipients of pacemakers implanted for bradyarrhythmias. State-of-the-art dual-chamber devices provide useful diagnostic information, including the number and duration of automatic mode switch episodes upon detection of ATA. In the recent ASSERT trial, with over 2.8 years of follow-up, (1) ATA were detected by the atrial high rate episode function in 36% of 2,580 pacemaker or implantable defibrillator recipients who had no history of ATA before device implantation, and (2) a 2.5-fold higher incidence of ischemic stroke or systemic embolism was observed in patients with than in patients without ATA detected by the atrial high rate function. 1,2 Therefore, accurate identification of ATA allows the planning of optimal antiarrhythmic and antithrombotic therapy. 3 However, the sensing of the far-field R-wave (FFRW) by the atrial channel may cause inappropriate mode switches from DDD to DDI mode, and trigger ATA or cause pacemaker syndrome. 4-14 Editorial p 582The right atrial appendage (RAA) is believed to be an unsuitable pacing site for the prevention of ATA, because it lengthens the inter-or intraatrial conduction time and increases the dispersion of atrial refractoriness. 15 Therefore, low atrial septal (LAS) pacing has been recommended instead of RAA pacing to prevent ATA, 16 though this remains to be confirmed by randomized clinical trial. 17 However, because the LAS region is closer to the ventricle than the RAA, it may be associated with a higher likelihood of FFRW oversensing, 16,18 though the prevalence and characteristics of FFRW sensing associated with LAS pacing have not been formally studied.We hypothesized that recipients of bipolar atrial leads with widely spaced tip-ring electrodes implanted in the LAS and who have left ventricular hypertrophy (LVH) on 12-lead ECG are at increased risk of FFRW sensing after ventricular pacing. To test this hypothesis, we measured the prevalence and examined the characteristics of FFRW sensing in recipients of dualchamber pacemakers, as well as the effects of the tip-ring Toshihisa Nagatomo, MD; Yutaka Otsuji, MD Background: Although low atrial septal (LAS) pacing may prevent atrial tachyarrhythmias in selected patients, farfield R-wave (FFRW) sensing in this region seems more likely than in the right atrial appendage.

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Section: Clinical Implications and Study Limitationsmentioning

confidence: 99%

Incidence and Characteristics of Far-Field R-Wave Sensing in Low Right Atrial Septum Pacing

Minamiguchi

Abe

Kohno

et al. 2012

Circ J

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“…13 Three features of the far-field signal should be considered, whether it is oversensed: relative amplitude, timing, and variability.…”

Section: Swerdlow Et Al Troubleshooting Icd Sensing II 213mentioning

confidence: 99%

Troubleshooting Implantable Cardioverter-Defibrillator Sensing Problems II

Swerdlow

Asirvatham

Ellenbogen

et al. 2015

Circ: Arrhythmia and Electrophysiology

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“…Our study supports previous findings that a bipolar configuration is superior in rejecting ventricular far fields depending on the programmed sensitivity. 1,3,10,14 …”

Section: Unipolar Versus Bipolar Measurementsmentioning

confidence: 99%

“…A single pacemaker device type was chosen to exclude the influence of different sense amplifiers and filters on the study result. Measurements were performed 7 ± 3 months (range [3][4][5][6][7][8][9][10][11][12][13][14] after implantation of the device and pacing leads. Patient age was 66 ± 10 years, 79% of patients were male.…”

Section: Patient Characteristics and Pacing Systemsmentioning

confidence: 99%

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Atrial Near‐Field and Ventricular Far‐Field Analysis by Automated Signal Processing at Rest and During Exercise

Eberhardt

Bonnemeier

Hofmann

et al. 2006

Noninvasive Electrocardiol

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Introduction: Sophisticated monitoring of atrial activity is a prerequisite for modern pacemaker therapy. Ideally, near-fields and ventricular far-fields ought to be distinguished by beat-to-beat template analysis of the atrial signal. A prerequisite is that atrial signals are stable under different conditions.Methods and Results: A Matlab routine was developed to analyze atrial electrograms of 23 patients at least 3 months after implantation of a dual chamber pacemaker under several conditions including at rest, bipolar at rest, in an upright position, during treadmill exercise, and postexercise. A near-field and far-field template was created and amplitudes, widths, and slew rates were measured. In bipolar configuration, near-field amplitude at rest was 3.04 ± 0.94 mV (unipolar)/3.36 ± 1.0 mV (bipolar) versus 3.18 ± 1.0 mV (bipolar) at peak exercise. Far-field amplitude at rest was 1.66 ± 1.18 (unipolar)/0.47 ± 0.27 mV (bipolar) and 0.41 ± 0.21 mV (bipolar) at peak exercise (n.s. for bipolar measurements). No overall significant changes were observed for near-and far-field widths and slew rates during exercise. Shorter tip-ring distances of the atrial bipole, lead position, and the presence of sinus node disease did not have any impact on overall near-and far-field signal characteristics. Intraindividual differences between rest and peak exercise were moderate (range: near-field +0.15 to −0.54 mV; range: far-field +0.05 to −0.18 mV).Conclusions: Atrial near and far fields can be automatically classified and quantified by automated signal processing. Signals did not change during exercise or change of posture. This is a prerequisite for the implementation of beat-to-beat template analysis into pacemakers.

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Stability of far field R wave signals in different conditions

Cited by 14 publications

References 17 publications

Incidence and Characteristics of Far-Field R-Wave Sensing in Low Right Atrial Septum Pacing

Incidence and Characteristics of Far-Field R-Wave Sensing in Low Right Atrial Septum Pacing

Troubleshooting Implantable Cardioverter-Defibrillator Sensing Problems II

Atrial Near‐Field and Ventricular Far‐Field Analysis by Automated Signal Processing at Rest and During Exercise

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