DeCaprio V, Hurzeler P, Furman S
Circulation. 1977 Nov;56(5):750-5. doi: 10.1161/01.cir.56.5.750.
Simultaneous unipolar and bipolar electrograms were recorded and compared from 49 pacemaker patients with bipolar endocardial electrodes. Average bipolar depolarization signal voltage equalled that of unipolar but showed greater variation. Bipolar and unipolar slew rates were equal in both mean and variance. The proximal pole voltage had little effect on the bipolar result in 8% of the cases, tended to cancel the tip voltage in 49% of the cases and augmented the tip voltage in 43% of the electrograms. The average bipolar R wave duration was 28% less, the T wave amplitude 34% less, and the ST-segment elevation 37% less than the unipolar values. By consistently attenuating the undersirable T waves and ST elevations, while leaving the depolarization signal unaffected, the bipolar electrode offered the advantage of a superior signal-to-noise ratio for sensing depolarization. In one case, however, the bipolar signal was so small as to cause a clinical sensing failure.
对49例使用双极心内膜电极的起搏器患者同时记录并比较了单极和双极心电图。双极去极化信号的平均电压与单极相等，但变化更大。双极和单极转换速率在均值和方差上均相等。在8%的病例中，近端电极电压对双极结果影响很小，在49%的病例中倾向于抵消尖端电压，在43%的心电图中增强了尖端电压。双极R波平均持续时间比单极短28%，T波振幅低34%，ST段抬高低37%。双极电极通过持续衰减不良的T波和ST段抬高，同时不影响去极化信号，提供了更高的去极化感知信噪比优势。然而，在1例病例中，双极信号过小导致临床感知失败。
