Far-Field Signal Reduction (FSR) Leads Minimize Atrial Oversensing and Inappropriate Mode Switches

Abstract

A Far-Field Signal Reduction (FSR) lead, essentially based on tip-to-ring electrode spacing and surface area optimization, has been demonstrated to be effective in reducing far field signal in the right atrium. This study used a custom 24 hour real time holter monitor to evaluate sensing characteristics of FSR leads versus regular pacing leads (SJM Tendril 1688T). 60 patients were randomized to either a FSR lead or a regular lead, placed at the RAA. At 10-day and 90-day follow up visits, each patient was put on a holter monitor for 24 hours real time IEGM recording. Detailed analysis of the recorded IGEM was conducted and any oversensing incidences were counted. Automatic mode switches due to atrial oversensing were counted between the two groups. The real time holter monitoring indicated that no atrial oversensing incidences occurred to the FSR patients versus about 20% of the control group. The number of inappropriate mode switches caused by oversensing in the control group was four times of that in the FSR patients. Atrial far field ventricular oversensing events were dramatically reduced by the FSR leads. FSR leads demonstrated clinical benefits of significantly decreasing the number of oversensing caused inappropriate mode switches.