Secemsky S I, Hauser R G, Denes P, Edwards L M
Pacing Clin Electrophysiol. 1982 Jan;5(1):10-9. doi: 10.1111/j.1540-8159.1982.tb02185.x.
Compared to bipolar lead configurations, unipolar pacing systems presumably enhance sensing of cardiac electrical events but are ore susceptible to electrical interference, including skeletal myopotentials. The incidence and clinical significance of oversensing and of undersensing by unipolar R-wave inhibited pacemakers in 228 patients were assessed by 24-hour Holter monitoring and/or by pectoral muscle exercises. Overall, 38% of patients exhibited oversensing and false inhibition due to skeletal myopotentials. Symptoms due to oversensing occurred in 14% of patients and 58% of these required corrective intervention. The presence of silastic coating on the pulse generator had no effect on the sensing of myopotentials. In addition, the incidence of undersensing as assessed by Holter monitoring was 17% despite adequate implantation R wave amplitudes. Thus, oversensing remains a major clinical problem when using unipolar pacemaker systems and their use has not eliminated undersensing.
与双极导联配置相比，单极起搏系统可能增强了对心脏电活动的感知，但更容易受到电干扰，包括骨骼肌电位。通过24小时动态心电图监测和/或胸肌运动，评估了228例患者中使用单极R波抑制型起搏器时感知过度和感知不足的发生率及临床意义。总体而言，38%的患者因骨骼肌电位出现感知过度和假性抑制。14%的患者出现了因感知过度导致的症状，其中58%需要进行纠正干预。脉冲发生器上硅橡胶涂层的存在对肌电位的感知没有影响。此外，尽管植入时R波振幅足够，但通过动态心电图监测评估的感知不足发生率仍为17%。因此，使用单极起搏器系统时，感知过度仍然是一个主要的临床问题，而且其使用并未消除感知不足。
