Diagnosis of Atrial Undersensing in Dual Chamber Pacemakers: Impact of Autodiagnostic Features
| Autor: | Hugo A. Katus, Uwe K.H. Wiegand, Regina Schneider, Jürgen Potratz, Henning Haase, Axel Brandes, Frank Bode |
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| Rok vydání: | 1999 |
| Předmět: |
Male
Pacemaker Artificial medicine.medical_specialty Atrial sensing Treadmill exercise Sensitivity and Specificity Electrocardiography Internal medicine medicine Humans Diagnosis Computer-Assisted cardiovascular diseases P wave amplitude Aged Aged 80 and over business.industry Significant difference Equipment Design General Medicine Middle Aged Electrocardiographic Finding Equipment Failure Analysis Heart Block Single lead Atrioventricular Node Electrocardiography Ambulatory Exercise Test cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Holter monitoring Holter ecg |
| Zdroj: | Pacing and Clinical Electrophysiology. 22:894-902 |
| ISSN: | 1540-8159 0147-8389 |
| DOI: | 10.1111/j.1540-8159.1999.tb06813.x |
| Popis: | Atrial undersensing occurs in a considerable number of patients, both with single lead VDD pacemakers and with DDD devices. The aim of this study was to investigate the diagnostic efficacy of electrocardiographic methods and autodiagnostic pacemaker features to detect atrial sensing dysfunction. Two hundred and thirty-one patients with AV block received single lead VDD pacemakers or DDD devices. Atrial sensitivity was programmed to 0.1 or 0.18 in VDD devices and to 0.5 mV in DDD devices; the rate limits were set to 40 and 160 beats/min. Twelve-lead ECG recording for 1 minute during deep respiration and change of body position, 24-hour Holter ECG recording, and treadmill exercise were performed 2 weeks and 15 months after pacemaker implantation. AV synchrony and, if available, P wave amplitude histogram were sampled by autodiagnostic pacemaker features and compared to electrocardiographic findings. Atrial undersensing was assumed, if AV synchrony was below 100% or if minimal P wave amplitude (PWA) was equal to the programmed atrial sensitivity. Intermittent atrial undersensing occurred in 20.7% of patients. The diagnostic sensitivities of the various methods used to detect atrial sensing failures were: 24-hour Holter monitoring 97.5%, P wave amplitude histogram 90.0%, stored AV synchrony 68.0% without significant difference between the various devices, treadmill exercise testing 58.8%, and 12-lead ECG recording 21.3%. In one patient, atrial undersensing was exclusively detected by exercise testing. In conclusion, autodiagnostic pacemaker features facilitate the evaluation of atrial sensing performance. However, to exclude intermittent atrial malesensing, routine Holter monitoring and treadmill exercise are still needed. |
| Databáze: | OpenAIRE |
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