Incidence and Characteristics of Far-Field R-Wave Sensing in Low Right Atrial Septum Pacing

Access this Article

Search this Article

Author(s)

    • ABE Haruhiko
    • Division of Cardiology, University of Occupational and Environmental Health
    • KOHNO Ritsuko
    • Division of Cardiology, University of Occupational and Environmental Health
    • OGINOSAWA Yasushi
    • Division of Cardiology, University of Occupational and Environmental Health
    • TAMURA Masahito
    • Division of Cardiology, University of Occupational and Environmental Health
    • TAKEUCHI Masaaki
    • Division of Cardiology, University of Occupational and Environmental Health
    • OTSUJI Yutaka
    • Division of Cardiology, University of Occupational and Environmental Health

Abstract

<b><i>Background:</i></b> Although low atrial septal (LAS) pacing may prevent atrial tachyarrhythmias in selected patients, far-field R-wave (FFRW) sensing in this region seems more likely than in the right atrial appendage. <b><i>Methods and Results:</i></b> We compared the clinical characteristics and prevalence of FFRW sensing in 31 recipients (mean age, 74±10 years) of dual-chamber pacemakers, randomly assigned to 10.0mm (n=15) vs. 1.1mm (n=16) tip-ring electrode spacing of bipolar atrial leads implanted in the LAS for management of bradyarrhythmias. The pacemakers were programmed to DDD mode with backup rates at 50-60beats/min. FFRW sensing was measured with atrial sensitivity set at 0.1mV, and increased in 0.1mV steps. Predictors of FFRW sensing were examined by multiple variable regression analysis, and hazard ratios (HR) and confidence intervals (CI) were calculated. At atrial sensitivities of 0.1 and 0.5mV, FFRW was sensed in 24 (77%) and 9 (29%) patients, respectively. A 10.0-mm tip-ring electrode spacing of the atrial lead (HR 10.3; 95%CI 1.0-102.7; P=0.047), and presence of left ventricular hypertrophy (LVH) on 12-lead ECG (HR 14.5, 95%CI 1.2-180.0; P=0.037) were independent predictors of FFRW sensing. <b><i>Conclusions:</i></b> The prevalence of FFRW sensing in the LAS region was high. A narrow spacing of the tip-ring electrodes is recommended in the LAS, particularly in the presence of LVH on ECG. (<i>Circ J</i> 2012; <b>76:</b> 598-606)<br>

Journal

  • Circulation Journal

    Circulation Journal 76(3), 598-606, 2012-02-25

    The Japanese Circulation Society

References:  28

Cited by:  1

Codes

  • NII Article ID (NAID)
    10030129755
  • NII NACSIS-CAT ID (NCID)
    AA11591968
  • Text Lang
    ENG
  • Article Type
    Journal Article
  • ISSN
    13469843
  • Data Source
    CJP  CJPref  J-STAGE 
Page Top