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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Intraoperative study of polarization and evoked response signals in different endocardial electrode designs.
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Intraoperative study of polarization and evoked response signals in different endocardial electrode designs.

机译：术中不同心内膜电极设计中极化和诱发反应信号的研究。

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Some new generation pacemakers use an algorithm based on evoked response (ER) detection to verify beat-to-beat capture and to enable automatic adjustment of output. This is a prospective acute study of polarization signal (PS) and ER in nine currently available electrodes. Intraoperative testing of ventricular bipolar electrodes used the Autocapture (AC) algorithm. The intrinsic R wave, PS, ER, acceptance of AC function, and stimulation thresholds (STs) were obtained. Ventricular electrodes were categorized as follows: titanium nitride (TiN)-coated passive and active fixation, high impedance (HI), passive fixation (VP), iridium oxide-coated titanium (IROX) (VI), and platinum helix (PH) active fixation. Acute testing was performed in 217 patients with an average age of 74.26 years, 59.6% were men with primary pacing indication-SSS (46.3%). There were no significant differences found with respect to R wave and threshold between the various electrodes. PH active-fixation electrodes had significantly higher ER and PS than other groups including the TiN-coated active-fixation electrodes. TiN-coated electrodes (active and passive fixation) had significantly lower PS than other electrodes. As a result, TiN electrodes had a significantly higher functional rate of AC (91.7%), whereas PH had the lowest rate (0%). In conclusion, (1) polarization characteristics are significantly different for commercially available ventricular electrodes, (2) certain physical features at the tissue to electrode interface like TiN coating appears to be more important in determining PS than electrode tip size and fixation method, and (3) the current algorithm for AC requires electrodes that provide low polarization for satisfactory performance.
机译：一些新一代起搏器使用基于诱发反应（ER）检测的算法来验证逐个拍子并实现输出的自动调整。这是对九种当前可用电极中的极化信号（PS）和ER的前瞻性急性研究。对心室双极电极的术中测试使用自动捕获（AC）算法。获得了固有的R波，PS，ER，AC功能的接受度和刺激阈值（ST）。心室电极的分类如下：氮化钛（TiN）涂层的被动和主动固定，高阻抗（HI），被动固定（VP），氧化铱涂层的钛（IROX）（VI）和铂螺旋（PH）活性固定。在217例平均年龄为74.26岁的患者中进行了急性检查，其中59.6％的患者具有原发性起搏指征-SSS（46.3％）。在各个电极之间，关于R波和阈值没有发现显着差异。 PH主动固定电极的ER和PS显着高于包括TiN涂层的主动固定电极在内的其他组。 TiN涂层电极（主动和被动固定）的PS显着低于其他电极。结果，TiN电极具有明显更高的交流电功能率（91.7％），而PH最低（0％）。总之，（1）对于市售的心室电极而言，极化特性存在显着差异;（2）在组织与电极之间的某些物理特征（如TiN涂层）似乎在确定PS中比电极尖端尺寸和固定方法更为重要，并且（ 3）当前用于AC的算法要求电极提供低极化以获得令人满意的性能。

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