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Article: Muscle noise effects on atrial evoked response sensing: Implications on atrial auto-threshold and auto-capture determination

TitleMuscle noise effects on atrial evoked response sensing: Implications on atrial auto-threshold and auto-capture determination
Authors
Issue Date2011
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pace - Pacing And Clinical Electrophysiology, 2011, v. 34 n. 4, p. 460-466 How to Cite?
AbstractBackground: Automatic pacing capture verification algorithms that are based on detection of local evoked response signals are susceptible to interference from myopotential noise. This is especially true in the atrium where the lower signal amplitude and signal-to-noise ratio make pacing capture verification more challenging. The aim of this study is to evaluate the impact of myopotential noise induced by various maneuvers on the atrial evoked response (AER) signal. Methods: Data were collected from 18 patients (7 M/11 F, 77.6 ± 8.8 years), implanted with a dual chamber rate response (DDDR) pacemaker and acute and chronic right atrial leads and right ventricular leads, at three regular follow-up visits scheduled at 1, 3, and 6 months after pacemaker implantation or replacement procedures. During each study visit, manual atrial pacing threshold tests during unipolar pacing in the DDD mode were conducted with two evoked response sensing configurations (RA Ring → Ind and RA Ring → V Tip) while patients performed six different maneuvers. Noise estimates were calculated for each maneuver. Results: The greatest noise estimates in both sensing configurations were measured during the hand-pressing exercise (0.649 ± 0.342 mV in the RA Ring → Ind vector, 0.309 ± 0.223 mV in the RA Ring → V Tip vector). No significant differences in overall noise estimates were observed between the follow-up visits. Of the beats that exhibited noise estimates greater than a sensing floor of 0.3 mV, up to 22% of cardiac beats had a signal-to-noise ratio less than 2 in the RA Ring → Ind configuration. Conclusions: Results indicate that myopotential noise generated by performing maneuvers has a demonstrable impact on AER sensing. Therefore, noise mitigation processes are necessary in atrial automatic pacing capture verification algorithms based on evoked response signals to identify and appropriately manage noise. ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/124901
ISSN
2015 Impact Factor: 1.156
2015 SCImago Journal Rankings: 0.662
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorSaha, Sen_HK
dc.contributor.authorGarg, Aen_HK
dc.contributor.authorBohn, Den_HK
dc.contributor.authorLee, YLen_HK
dc.contributor.authorLau, CPen_HK
dc.date.accessioned2010-10-31T11:00:30Z-
dc.date.available2010-10-31T11:00:30Z-
dc.date.issued2011en_HK
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2011, v. 34 n. 4, p. 460-466en_HK
dc.identifier.issn0147-8389en_HK
dc.identifier.urihttp://hdl.handle.net/10722/124901-
dc.description.abstractBackground: Automatic pacing capture verification algorithms that are based on detection of local evoked response signals are susceptible to interference from myopotential noise. This is especially true in the atrium where the lower signal amplitude and signal-to-noise ratio make pacing capture verification more challenging. The aim of this study is to evaluate the impact of myopotential noise induced by various maneuvers on the atrial evoked response (AER) signal. Methods: Data were collected from 18 patients (7 M/11 F, 77.6 ± 8.8 years), implanted with a dual chamber rate response (DDDR) pacemaker and acute and chronic right atrial leads and right ventricular leads, at three regular follow-up visits scheduled at 1, 3, and 6 months after pacemaker implantation or replacement procedures. During each study visit, manual atrial pacing threshold tests during unipolar pacing in the DDD mode were conducted with two evoked response sensing configurations (RA Ring → Ind and RA Ring → V Tip) while patients performed six different maneuvers. Noise estimates were calculated for each maneuver. Results: The greatest noise estimates in both sensing configurations were measured during the hand-pressing exercise (0.649 ± 0.342 mV in the RA Ring → Ind vector, 0.309 ± 0.223 mV in the RA Ring → V Tip vector). No significant differences in overall noise estimates were observed between the follow-up visits. Of the beats that exhibited noise estimates greater than a sensing floor of 0.3 mV, up to 22% of cardiac beats had a signal-to-noise ratio less than 2 in the RA Ring → Ind configuration. Conclusions: Results indicate that myopotential noise generated by performing maneuvers has a demonstrable impact on AER sensing. Therefore, noise mitigation processes are necessary in atrial automatic pacing capture verification algorithms based on evoked response signals to identify and appropriately manage noise. ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_HK
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_HK
dc.subject.meshAction Potentialsen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshArtifactsen_HK
dc.subject.meshCardiac Pacing, Artificial - methodsen_HK
dc.subject.meshDiagnosis, Computer-Assisted - methodsen_HK
dc.subject.meshElectrocardiography, Ambulatory - methodsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHeart Failure - diagnosis - physiopathology - prevention & controlen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMuscle, Skeletal - physiopathologyen_HK
dc.subject.meshReproducibility of Resultsen_HK
dc.subject.meshSensitivity and Specificityen_HK
dc.subject.meshTherapy, Computer-Assisted - methodsen_HK
dc.titleMuscle noise effects on atrial evoked response sensing: Implications on atrial auto-threshold and auto-capture determinationen_HK
dc.typeArticleen_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1540-8159.2010.02992.xen_HK
dc.identifier.pmid21208231-
dc.identifier.scopuseid_2-s2.0-79953802842en_HK
dc.identifier.hkuros173638en_HK
dc.identifier.hkuros225166-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79953802842&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume34en_HK
dc.identifier.issue4en_HK
dc.identifier.spage460en_HK
dc.identifier.epage466en_HK
dc.identifier.isiWOS:000289159000012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridSaha, S=36937748400en_HK
dc.identifier.scopusauthoridGarg, A=49461260100en_HK
dc.identifier.scopusauthoridBohn, D=49461045100en_HK
dc.identifier.scopusauthoridLee, YL=49461474100en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.citeulike9119846-

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