Abstract
Purpose was to test a new Atrial Auto Threshold (AAT) algorithm at implant in patients (pts) with acute or chronic atrial leads. The algorithm is based upon independent atrial pacing and evoked response (ER) sensing configuration. A Guidant Insignia2AT study device was connected to implanted atrial leads, an empty can was used to facilitate the measurements. Randomized series of atrial threshold tests (pulse duration 0.4ms) were performed while recording surface ECG and intracardiac electrograms. Data from 26 pts (15M/11F; 72.6±10.8 yrs), were studied. All pts received a DDD(R) pacemaker with bipolar atrial lead from various manufacturers. AAT tests were run in DDD (11 pts) or in AAI mode (15 pts), with 15 acute/11 chronic (6.4±3.1 yrs) atrial leads. Initially, 18/26 pts presented with various failures. Solutions were implemented and data were evaluated against the new AAT algorithm, resulting in successful AAT testing in 25/26 (96%) pts. Testing failed in 1 patient because atrial ER signal amplitudes were below the absolute minimum value. The new AAT algorithm using independent atrial pacing and ER sensing configuration can be implemented in pacemakers.
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