Atrial septal pacing: A method for pacing both atria simultaneously

被引:49
作者
Spencer, WH
Zhu, DWX
Markowitz, T
Baddruddin, SM
Zoghbi, WA
机构
[1] BAYLOR COLL MED,HOUSTON,TX 77030
[2] MEDTRONIC INC,MINNEAPOLIS,MN
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 1997年 / 20卷 / 11期
关键词
atrial leads; atrial pacing; atrioventricular timing; atrial tachyarrhythmias; transesophageal echocardiography; atrial septum;
D O I
10.1111/j.1540-8159.1997.tb05431.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
By pacing both atria simultaneously, one could reliably predict and optimize left-sided AV timing without concern for IACT. With synchronous depolarization of the atria, reentrant arrhythmias might be suppressed. We studied four male patients (73 +/- 3 years) with paroxysmal atrial fibrillation and symptomatic bradyarrhythmias using TEE and fluoroscopy as guides; a standard active fixation screw-in lead (Medtronic model #4058) was attached to the interatrial septum and a standard tined lead was paced in the ventricle. The generators were Medtronic model 7960. The baseline ECG was compared to the paced ECG and the conduction time were measured to the high right atrium, distal coronary sinus and atrial septum in normal sinus rhythm, atrial septal pacing, and AAT pacing. On the surface EGG, no acceleration or delay in AV conduction was noted during AAI pacing from the interatrial septum as compared with normal sinus rhythm. The mean interatrial conduction time for all 4 patients was 106 +/- 2 ms; the interatrial conduction time measured during AAT pacing utilizing the atrial septal pacing lead was 97 +/- 4 ms (P = NS). During atrial septal pacing, the mean conduction time to the high right atrium was 53 +/- 2 ms. The mean conduction time to the lateral left atrium during atrial septal pacing, was likewise 53 +/- 2 ms. We conclude that it is possible to pace both atria simultaneously from a single site using a standard active fixation lead guided by TEE and fluoroscopy. Such a pacing system allows accurate timing of the left-sided AV delay.
引用
收藏
页码:2739 / 2745
页数:7
相关论文
共 13 条
  • [1] CAZEAU S, 1994, PACE, V17, P1001
  • [2] DAUBERT C, 1994, ARCH MAL COEUR, V87, P1469
  • [3] Daubert C, 1994, EUR JCPE, V1, P35
  • [4] ISHIKAWA T, 1993, EUR J CPE, V2, P140
  • [5] THE HEMODYNAMIC BENEFIT OF DIFFERENTIAL ATRIOVENTRICULAR DELAY INTERVALS FOR SENSED AND PACED ATRIAL EVENTS DURING PHYSIOLOGIC PACING
    JANOSIK, DL
    PEARSON, AC
    BUCKINGHAM, TA
    LABOVITZ, AJ
    REDD, RM
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1989, 14 (02) : 499 - 507
  • [6] KARLHEINZ S, 1995, PACE, V18, P810
  • [7] A COMPARISON OF THE ACUTE AND LONG-TERM HEMODYNAMIC-EFFECTS OF VENTRICULAR INHIBITED AND ATRIAL SYNCHRONOUS VENTRICULAR INHIBITED PACING
    KRUSE, I
    ARNMAN, K
    CONRADSON, TB
    RYDEN, L
    [J]. CIRCULATION, 1982, 65 (05) : 846 - 855
  • [8] A NEW PACING ALGORITHM FOR OVERDRIVE SUPPRESSION OF ATRIAL-FIBRILLATION
    MURGATROYD, FD
    NITZSCHE, R
    SLADE, AKB
    LIMOUSIN, M
    ROSSET, N
    CAMM, AJ
    RITTER, P
    [J]. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1994, 17 (11): : 1966 - 1973
  • [9] PRAKASH A, 1996, PACE, V19, P618
  • [10] PRAKASH A, 1995, PACE, V18, P809