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Electrophysiological effects of biatrial pacing evaluated by means of signal-averaged P wave time-domain parameters. The significance of persistent atrial late potentials in right atrium during biatrial pacing
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Abstract
Methods: Recordings were performed on 24 patients during BiA pacing system implantation. A surface SA-ECG was obtained from orthogonal leads, and intraatrial signals were recorded and averaged separately from the right and left atria at sinus rhythm and BiA pacing. We analyzed standard SA-ECG parameters (P/A wave duration, RMS20 and LAS5) and the presence of atrial late potentials (ALP-Pdur > 125 ms and RMS20 < 2.40 mV).
Results and conclusions: BiA pacing favorably modifies SA-ECG parameters in the right and left atrium. BiA pacing significantly shortens P duration, significantly increases RMS20 and reduces atrial late potentials (ALP) occurrence in most patients in comparison to sinus rhythm both atria. ALP are still present in 46% of patients in spite of effective BiA pacing, which can be observed mainly in the right atrium and is connected with increased risk of atrial fibrillation recurrence. This phenomenon suggests a limited effect of RAA-based BiA pacing on the synchrony of atrial activation, and a search is needed for another right atrial lead location for permanent BiA pacing. (Cardiol J 2008; 15: 26-38)
Abstract
Methods: Recordings were performed on 24 patients during BiA pacing system implantation. A surface SA-ECG was obtained from orthogonal leads, and intraatrial signals were recorded and averaged separately from the right and left atria at sinus rhythm and BiA pacing. We analyzed standard SA-ECG parameters (P/A wave duration, RMS20 and LAS5) and the presence of atrial late potentials (ALP-Pdur > 125 ms and RMS20 < 2.40 mV).
Results and conclusions: BiA pacing favorably modifies SA-ECG parameters in the right and left atrium. BiA pacing significantly shortens P duration, significantly increases RMS20 and reduces atrial late potentials (ALP) occurrence in most patients in comparison to sinus rhythm both atria. ALP are still present in 46% of patients in spite of effective BiA pacing, which can be observed mainly in the right atrium and is connected with increased risk of atrial fibrillation recurrence. This phenomenon suggests a limited effect of RAA-based BiA pacing on the synchrony of atrial activation, and a search is needed for another right atrial lead location for permanent BiA pacing. (Cardiol J 2008; 15: 26-38)
Keywords
signal-averaged ECG; biatrial pacing; intraatrial signal; atrial late potentials; atrial fibrillation


Title
Electrophysiological effects of biatrial pacing evaluated by means of signal-averaged P wave time-domain parameters. The significance of persistent atrial late potentials in right atrium during biatrial pacing
Journal
Issue
Pages
26-38
Published online
2007-12-17
Page views
505
Article views/downloads
877
Bibliographic record
Cardiol J 2008;15(1):26-38.
Keywords
signal-averaged ECG
biatrial pacing
intraatrial signal
atrial late potentials
atrial fibrillation
Authors
Andrzej Kutarski
Andrzej Głowniak
Dorota Szczęśniak
Piotr Ruciński