Simultaneous atrial and ventricular electrogram transmission via a specialized single lead system.

Abstract

No telemetrically monitorable pacemakers are capable of detecting and transmitting the complete electrogram (EGM) during normal and paced rhythms, although some are capable of detecting and transmitting either the P- or R-wave. A new lead and telemetry-pacemaker system has been developed that permits the transmission of the complete EGM and is not adversely affected by pacemaker outputs or after-potentials. Electrodes are placed in the right ventricle and atrium to optimize EGM detection. These A-V data probe electrodes are electrically separate from the pacing-sensing electrodes but are structurally part of a coaxial ventricular lead that is no larger than a conventional bipolar lead (2.3 mm). The telemetry system is also compatible with telephone monitoring systems. The system has consistently demonstrated its ability to detect accurately the EGM during normal sinus rhythms and does not affect atrial, ventricular, or A-V sequential pacing. In addition, this system can detect and transmit EGM abnormalities, including ectopic beats, retrograde conduction, and ischemic changes. A-V data leads with telemetry monitored VVI pacemakers have been implanted in dogs for over two years. This system will provide the means to detect and telemetrically record noninvasively the entire normal and abnormal EGM, even in pacer dependent patients. (PACE, Vol. 7, November-December, 1984).