Key result
Atrial pacing thresholds were higher than ventricular thresholds at implantation (P<0.00005), but postoperative threshold rise and thresholds at 1 and 12 months did not differ significantly.
Why the study?
Does the development of pacing thresholds differ between atrial and ventricular identical carbon-tip leads during the first postoperative year in patients with DDD pacemakers?
Observational (n=57)
Does the development of pacing thresholds differ between atrial and ventricular identical carbon-tip leads during the first postoperative year in patients with DDD pacemakers?
In patients with DDD pacemakers, atrial pacing thresholds are higher than ventricular thresholds at implantation, but chronic thresholds at 1 and 12 months do not differ significantly.
Answers are grounded in this paper and cite their sources.
Similar chronic thresholds despite higher initial atrial values; hypothesis-generating for lead performance in DDD pacing and requires prospective confirmation.
The atrial and ventricular pacing threshold development during the first postoperative year was studied in a group of patients receiving DDD pacemakers. Identical carbon-tip endocardial leads were implanted in atrium and ventricle. Atrial and ventricular voltage stimulation thresholds were measured at implantation, and noninvasively at 1 and 12 months thereafter. The atrial amplifier sensitivity required for adequate P wave sensing during follow-up was also determined. The possible influence of a number of factors upon atrial and ventricular threshold evolution was statistically assessed. The threshold data were complete in 57 patients (mean age +/- SD, 65.2 +/- 12.4 years). Thirteen patients had a diagnosis of sinus node disease, whereas 44 had not. Patient age and diagnosis did not significantly influence atrial or ventricular stimulation threshold development. Atrial sensing thresholds were not related to atrial stimulation thresholds during follow-up. Atrial pacing thresholds were higher than ventricular thresholds at pacemaker implantation (P less than 0.00005), but the postoperative threshold rise and thresholds at 1 and 12 months postoperatively did not differ significantly between the atrium and ventricle. The ratio of chronic to acute stimulation thresholds was higher on the ventricular than on the atrial level (0.001 greater than P greater than 0.0005). The chronic atrial threshold showed a logarithmic relation to the threshold at implantation (P = 0.0006); postoperative threshold rise was not a significant determinant of the chronic atrial threshold (P = NS). On the ventricular level, the reverse was seen: The chronic threshold was related to the postoperative threshold rise (P = 0.0015, logarithmic relation), but not to the implantation threshold (P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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Brandt et al. (1990) conducted an observational in DDD pacemaker implantation (n=57). Atrial carbon-tip endocardial lead vs. Ventricular carbon-tip endocardial lead was evaluated on Postoperative threshold rise and thresholds at 1 and 12 months (p=NS). Atrial pacing thresholds were higher than ventricular thresholds at implantation (P<0.00005), but postoperative threshold rise and thresholds at 1 and 12 months did not differ significantly.
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