Cardiac Pacing pp 335-339 | Cite as

Atrial Amplitude Mapping to Avoid P Wave Sensing Failure

  • Takuro Misaki
  • Takashi Iwa
  • Tasuhiro Matsunaga
Conference paper

Summary

Physiological pacemaker implantations are increasing in number. However, P wave sensing failure is still a major problem. To determine the best atrial electrode positioning for P wave sensing, the atrial amplitude was measured in 10 dogs, from various epicardial sites, including the endocardium of both appendages. During sinus rhythm, maximum amplitude was obtained from the left atrial free wall. High amplitude was also obtained from the right atrial free wall. However, only low amplitudes were obtained from both appendages. During junctional rhythm, which was obtained by cryosurgery of the sinus node area, patterns of atrial and amplitude mapping changed, but maximum amplitude areas were present on the atrial free walls. Also, atrial amplitude mapping was tried in four clinical cases of WPW -syndrome, during surgery. The maximum amplitude area of the right atrium was located, not on the appendage, but on the free wall, in all cases. These results suggest that J shaped electrode fixation is not adequate to P wave sensing. Even if left a atrial free wall fixation is advisable, this requires a left thoracotomy. Therefore, transvenous fixation to the right free wall should be selected, possibly using a screw-in method.

Keywords

Catheter Respiration 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Smyth NPD, Vasarhelyi L, McNamra W, Kakascik GE: A permanent transvenous atrial electrode catheter. J Thoracic Cardiovasc Surg 1969; 58: 773–782.Google Scholar
  2. 2.
    Nathan D, Center S, Wu C: An implantable synchronous pacemaker for long term term correction of the complete heart block. A, J Cardiol 1963; 11: 362–367.CrossRefGoogle Scholar
  3. 3.
    Sutorius DJ: Use of an endocardial corkscrew lead for atrial pacing. In: Meere C, ed. Proceedings of the 6th world symposium on cardiac pacing. Montreal: Pacesymp 1979; Chap 33: 5.Google Scholar
  4. 4.
    Todo K, Kaneko S, Fujiwara T, Sugiki K, Tanaka N, Komastu S: Patient-controlled rapid atrial pacing in long term management of recurrent supraventricular tachycardias. In: Meere C, ed. Proceedings of the 6th World symposium on cardiac pacing. Montreal: Pacesymp 1979; Chap 9: 6.Google Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt 1983

Authors and Affiliations

  • Takuro Misaki
    • 1
  • Takashi Iwa
  • Tasuhiro Matsunaga
  1. 1.Department of SurgeryKanazawa University School of MedicineKanazawa 920Japan

Personalised recommendations