Hartung W M, Hartung D, Saad H, Mittag A, Mahnkopf D, Klein H U, Willems R
University Hospital Magdeburg and Institute of Medicine Technology Magdeburg, Germany.
J Interv Card Electrophysiol. 2000 Jun;4(2):405-13. doi: 10.1023/a:1009858601764.
Pace prevention of atrial tachyarrhythmias is based in part on the reduction of intra-atrial (IAA) and/or inter-atrial (IEA) conduction. We previously introduced a novel pacing mode using floating atrial ring electrodes on a VDD-lead (BIdirectional MO nophasic impulSe: BIMOS). The effects of BIMOS pacing on IAA and IEA conduction times has not been studied. In nine Merino sheep electrode catheters were placed at the His-Bundle (HBE), high right atrium (HRA), coronary sinus ostium (Cs-Os), and left lateral atrium (LLA). A VDD-lead was introduced with floating electrodes in the high and mid right atrium (Floating). IAA (S/P-HRA, S/P-Cs-Os, S/P-HBE, S/P-Floating), IEA conduction times (S/P-LLA), and P-wave duration (PD) were measured during sinus rhythm (S), during bipolar cathodal pacing (P) in the HRA, in the Cs-Os position, as well as during BIMOS floating pacing. The mean PD during S was significantly shorter than during HRA- (66. 6+/-12.8ms; vs. 116.2+/-11.1ms; p<0.05) and Cs-Os-P (66.6+/-12.8ms vs. 94.4+/-9.0ms; p<0.05). In comparison to HRA-P, BIMOS configuration lead to a significant reduction of the P-wave duration (116.2+/-11.1ms vs. 85. 4+/-8.8ms; p<0.05). During BIMOS pacing, the global atrial conduction time was significantly shorter than during pacing in the HRA and Cs-Os position. The results of this study demonstrate a clear reduction of IAA and IEA conduction times using BIMOS configurations compared to conventional HRA-P. Furthermore, BIMOS pacing produced a more homogeneous atrial activation when compared with conventional HRA- and Cs-Os-P.
房性快速心律失常的起搏预防部分基于房内（IAA）和/或房间（IEA）传导的减少。我们之前引入了一种在VDD导线上使用浮动心房环电极的新型起搏模式（双向单极脉冲：BIMOS）。BIMOS起搏对IAA和IEA传导时间的影响尚未得到研究。在9只美利奴绵羊中，将电极导管放置在希氏束（HBE）、高位右心房（HRA）、冠状窦口（Cs-Os）和左外侧心房（LLA）。引入一根在高位和中位右心房带有浮动电极的VDD导线（浮动）。在窦性心律（S）期间、在HRA进行双极阴极起搏（P）期间、在Cs-Os位置以及在BIMOS浮动起搏期间，测量IAA（S/P-HRA、S/P-Cs-Os、S/P-HBE、S/P-浮动）、IEA传导时间（S/P-LLA）和P波持续时间（PD）。S期间的平均PD显著短于HRA-P期间（66.6±12.8毫秒；对比116.2±11.1毫秒；p<0.05）和Cs-Os-P期间（66.6±12.8毫秒对比94.4±9.0毫秒；p<0.05）。与HRA-P相比，BIMOS配置导致P波持续时间显著缩短（116.2±11.1毫秒对比85.4±8.8毫秒；p<0.05）。在BIMOS起搏期间，整体心房传导时间显著短于在HRA和Cs-Os位置起搏期间。本研究结果表明，与传统的HRA-P相比，使用BIMOS配置可明显减少IAA和IEA传导时间。此外，与传统的HRA-和Cs-Os-P相比，BIMOS起搏产生的心房激动更均匀。
