RT-25
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Atrial stimulation by means of
floating electrodes: evaluation of different pacing configurations
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Matteo Di Biase, Giovanni Luzzi,
Matteo Anaclerio, Daniela Casella, Maria Vittoria Pitzalis, Paolo Rizzon.
Istituto di Cardiologia, Universita degli Studi, Bari, Italy
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Major limitations of DDD pacing utilizing a single
lead with floating electrodes in the atrium are the impossibility, in some patients, of
obtaining stable atrial capture and the parasitic contractions of the diaphragm which
preclude long term stimulation1-10. The latter
complication occurs due to depolarization of atrial cells being obtained by means of an
electric field generated near the floating dipole electrodes. The same electric field also
induces depolarization of the phrenic nerve which stimulates the diaphragm. This side
effect is not tolerated by the patients and limits the use of the single lead for atrial
stimulation.
In order to reduce this side effect it could be of some utility to find a stimulation
configuration capable of reducing the atrial threshold, maximizing the difference between
atrial and diaphragmatic thresholds and permitting a stable atrial stimulation in supine
and standing positions.
The aim of this study was to test different configurations for atrial pacing with
single lead and floating electrodes, in order to find the highest threshold difference in
atrial and diaphragmatic stimulation.
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