Hazday M S, Mendelson D, Brownlee R R
Division of Cardiology, Orlando Regional Healthcare Systems Orlando, Florida, USA.
J Interv Card Electrophysiol. 1998 Jun;2(2):171-3. doi: 10.1023/a:1009755616342.
The clinical utility of single lead, atrial synchronous, ventricular pacing (VDD), for patients with normal sinus function and heart block is well established. Atrial stimulation, unavailable in VDD systems presents a significant disadvantage. DDD pacing systems however, require the introduction and positioning of two separate leads. The acute human study discussed evaluated a modified version of a commercially available VDD lead with a preshaped lobe, capable of both sensing and pacing the right atrium. "P" waves and atrial stimulation thresholds were determined in five patients. The mean P-wave was 2.5 +/- 1 millivolts. Atrial stimulation in the unipolar configuration was 1.6 +/- 0.5 volts and 1.7 +/- 0.9 volts in the bipolar configuration. These acute stimulation thresholds and sensing amplitudes were comparable to conventional DDD pacing systems. Therefore, single-lead DDD pacing may be feasible and warrants further study.