Wetzig T, Fischer G, Worth H, Hardt R, Hubmann M, Bolz A, Schaldach M
Zentralinstitut für Biomedizinische Technik, Universität Erlangen-Nürnberg.
Biomed Tech (Berl). 1995 Jan-Feb;40(1-2):9-13.
The aim of this study was to evaluate the ventricular evoked response (VER) measured with unipolar fractally coated pacing leads for use with rate-responsive pacemakers. To this end, the morphology of the VER, its variation with pacing rate and various levels of physical loading, and the long-term stability of the signal were studied using the telemetric features of implantable pacemakers. Fractally coated electrodes were used in order to minimize the stimulation artefact, thus enabling a reliable unipolar measurement of the VER. The VER shows uniform basic morphology, and remains virtually unchanged after 3 months; moreover, frequency and load-dependent changes of VER morphology were identical for all patients. A special programming device has been developed to evaluate a rate adaptive algorithm for optimizing the pacing rate to the current loading situation, and was successfully tested in two patients. The algorithm was shown to be capable of calculating a heart rate adequate for haemodynamic demand.
本研究的目的是评估使用单极分形涂层起搏导线与频率适应性起搏器配合时所测得的心室诱发反应（VER）。为此，利用植入式起搏器的遥测功能研究了VER的形态、其随起搏频率和不同程度体力负荷的变化以及信号的长期稳定性。使用分形涂层电极以尽量减少刺激伪迹，从而能够可靠地进行VER的单极测量。VER显示出一致的基本形态，3个月后基本保持不变；此外，所有患者VER形态的频率和负荷依赖性变化均相同。已开发出一种特殊的编程设备来评估一种速率自适应算法，该算法可根据当前负荷情况优化起搏频率，并在两名患者中成功进行了测试。结果表明该算法能够计算出满足血流动力学需求的心率。
