RT-38
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Long term clinical evaluation of
VDD pacing with a single pass lead
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L. Pavia, G. Cannava, C.
Silipigni, F. Casella, A. Cordiani, F.N. Longo.
Cardiac Pacing Section, Department of Cardiology, "Azienda Piemonte Hospital",
Messina, Italy
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Abstract
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Ventricular stimulation synchronized by spontaneous
atrial activity (VDD pacing) results in substantial hemodynamic and symptomatic benefits
in pts with AV block. Different models of single AV leads have been designed and many
clinical studies have assessed the clinical reliability of these systems. This study was
designed to test the possibility of using the same floating electrodes by assessing
appropriate P-wave sensing in different patient positions and during long-term follow-ups.
Thirty-five pts with second or third degree AV block and normal sinus rhythm were
implanted with Medtronic Thera VDD Pacemakers and Medtronic Capsure VDD Single Pass Leads.
Implantation data (P- and R-wave amplitude, atrial sensing threshold, ventricular
threshold and impedance); at implantation a P-wave amplitude less than 1 mV was not
accepted. Follow-up protocol consisted of symptoms review, pacing interrogation by
telemetry, ECG and Holter monitoring in needed before hospital dismissal, at 1 and 3
months and at 6 and 12 months after implantation. Atrial sensing threshold was measured
with Medtronic Telemetric Programmer 9790 in the following pts position: supine, sitting,
standing, during deep inspiration while sitting.
Atrial synchrony was considered satisfactory when POS was at least stability of post
implant P-wave amplitude is an important requisite for VDD pacing. Appropriate programming
of atrial sensitivity remained stable in long-term follow-ups. P-wave amplitude
significant changes of the related to pts posture cofirming that Thera Single Pass Lead
Pacing is a reliable and efficacious pacing modality for pts with stable AV block and a
healthy sinus node.
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Key Words
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Pacing
VDD pacemakers, follow-up, single pass lead, OA
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