Papouchado M, Crick J C
Bristol Heart Institute, United Kingdom.
Pacing Clin Electrophysiol. 1996 Nov;19(11 Pt 2):1772-6. doi: 10.1111/j.1540-8159.1996.tb03222.x.
The atrial sensing capabilities of a new single pass lead VDD pacing system (Pacesetter AddVent) were assessed in a prospective multicenter study of 101 implants during the period July 1994 through March 1996. The pacing lead (Pacesetter AV Plus) has a unique quadripolar 4-in-line connector and uses a pair of ring electrodes with an interelectrode spacing of 12 mm for atrial sensing. The mean age of the patients (51 men) was 73 years (range 19-91). Seventy-five patients had complete heart block; the others had 2:1 AV block. Wide variations were found in signal amplitude: mean P wave amplitude, measured over four cycles in the supine position, was 2.4 +/- 1.9 mV at implant, dropping to 1.9 +/- 1.7 mV predischarge, and remaining constant at follow-up but with a narrower range. Holter monitoring was undertaken in 24 patients, with a total of 550 monitored hours. Mean AV synchrony was 98.2% +/- 4.6% (excluding premature ventricular contractions), with 20 patients (83%) showing > 99% AV synchrony, with atrial sensing at 0.1 mV where needed. No oversensing was observed in any patient. There was a low incidence of atrial fibrillation (2%) and sinus bradycardia (0%). The findings show that the range of atrial signals, although wide initially, converges over the first year and remains adequate for reliable AV synchronous pacing.
在1994年7月至1996年3月期间，对一种新型单通道VDD起搏系统（百盛公司的AddVent）的心房感知能力进行了一项前瞻性多中心研究，涉及101例植入患者。起搏导线（百盛公司的AV Plus）具有独特的四极4线式连接器，并使用一对电极间距为12 mm的环形电极进行心房感知。患者（51名男性）的平均年龄为73岁（范围19 - 91岁）。75例患者患有完全性心脏传导阻滞；其他患者为2:1房室传导阻滞。发现信号幅度存在很大差异：在仰卧位测量四个心动周期的平均P波幅度，植入时为2.4±1.9 mV，出院前降至1.9±1.7 mV，随访时保持稳定但范围变窄。对24例患者进行了动态心电图监测，总监测时长为550小时。平均房室同步率为98.2%±4.6%（不包括室性早搏），20例患者（83%）的房室同步率>99%，必要时心房感知阈值为0.1 mV。未观察到任何患者存在感知过度。心房颤动（2%）和窦性心动过缓（0%）的发生率较低。研究结果表明，心房信号的范围虽然最初较宽，但在第一年趋于稳定，并且仍足以实现可靠的房室同步起搏。
