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

• Minamiguchi Hitoshi

  Division of Cardiology, University of Occupational and Environmental Health

• Abe Haruhiko

  Division of Cardiology, University of Occupational and Environmental Health Department of Heart Rhythm Management, 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

• Nagatomo Toshihisa

  Division of Cardiology, University of Occupational and Environmental Health

• Otsuji Yutaka

  Division of Cardiology, University of Occupational and Environmental Health

抄録

Background: 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. Methods and Results: 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. Conclusions: 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. (Circ J 2012; 76: 598-606)<br>

収録刊行物

• Circulation Journal

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

  一般社団法人 日本循環器学会

キーワード

• Dual-chamber pacing
• Far-field R wave
• Left ventricular hypertrophy
• Low atrial septum
• Tip-ring electrode spacing

詳細情報

• CRID: 1390282680081906688
• NII論文ID: 10030129755
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-11-0745
• COI: 1:STN:280:DC%2BC383lvVWksA%3D%3D
• ISSN: 13474820
• ISSN: 13469843
• PubMed: 22146754
• Web Site: http://www.jstage.jst.go.jp/article/circj/76/3/76_CJ-11-0745/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2012244825
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
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