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Left atrial far-field sensing by left ventricular leads: a potential hazard in cardiac resynchronisation therapy.
- Source :
-
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2005 Nov; Vol. 7 (6), pp. 611-6. Date of Electronic Publication: 2005 Sep 21. - Publication Year :
- 2005
-
Abstract
- Background: Cardiac resynchronisation therapy (CRT) requires a lead advanced through the coronary sinus (CS) to pace the left ventricle (LV). Left atrial far-field signals (LAFFS) may be sensed by the LV lead at the time of implant or after lead dislodgement, and may inhibit ventricular pacing.<br />Objective: To assess the incidence of detection of LAFFS > 2 mV and its correlation with the CS lead position.<br />Methods: Data from the first 75 consecutive patients enrolled in the InSync III multicentre study were analysed. The position of the LV lead was recorded at implant. During follow-up, pacing was temporarily inhibited and the LV channel electrogram was recorded. The amplitude of LAFFS observed before discharge from the hospital and at 1 month of follow-up was retrospectively analysed. A LAFFS > 2 mV was considered clinically significant.<br />Results: CRT systems were successfully implanted in 71 of 75 patients. A LAFFS > 2 mV was recorded by the LV lead channel in six of 71 patients (8.5%). This phenomenon developed between hospital discharge and 1 month of follow-up in two of these patients and in one case disappeared within 1 month. It was observed in all CS tributaries except the anterior and mid-cardiac veins.<br />Conclusions: Left atrial far-field signals sensed by the LV lead were not rare. Implanting physicians should be aware of this phenomenon in order to prevent potentially serious complications.
Details
- Language :
- English
- ISSN :
- 1099-5129
- Volume :
- 7
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 16216765
- Full Text :
- https://doi.org/10.1016/j.eupc.2005.07.005