Avoid FFS – Use of the Atrial Pacemaker Lead 1699 With Very Short Tip Ring Spacing to Avoid Far Field Sensing

Overview

The purpose of this study is to evaluate the possibility to program the shortest possible Post Ventricular Atrial Blanking Period (PVAB) and high sensitivity without getting inappropriate Mode Switch due to Far Field R-Wave sensing when using the new Tendril 1699T lead. Comparison with Tendril 1688T or 1388T with optimized Post Ventricular Atrial Blanking (PVAB).

Full Title of Study: “Atriale Vorhofsonde 1699 Mit Sehr Kurzem Bipolabstand Zur Vermeidung Von Far Field Sensing”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: Single (Participant)
  • Study Primary Completion Date: May 2008

Detailed Description

Far-field R-wave sensing (FFS) in the atrial channel of dual chamber pacemakers is a relevant source for inappropriate Mode Switch from the DDD mode to the DDI or VDI mode. Inappropriate loss of atrioventricular synchrony due to false positive Mode Switch is hemodynamically disadvantageous, may induce atrial tachyarrhythmias, can lead to pacemaker syndrome, and impairs the reliability of pacemaker Holter data. The aim of the study is to determine whether the use of a new atrial screw in lead with ultra short tip-ring distance of 1.1 mm (Study Group) eliminates the need for individual adjustment of the postventricular atrial blanking period (PVAB) based on an additional test in the Control Group with standard leads.

Interventions

  • Device: pacemaker implantation
    • St. Jude Medical Dual Chamber Pacemaker model Identity (ADx) DR, Victory DR, or newer

Arms, Groups and Cohorts

  • Active Comparator: 1699T (Optisense)
    • Implantation of the Optisense Lead 1699T, programming of the shortest possible postventricular atrial blanking period (PVAB)
  • Active Comparator: Standard lead
    • Implantation of a standard bipolar atrial pacing lead. Optimization of the postventricular atrial blanking period (PVAB) after implantation.

Clinical Trial Outcome Measures

Primary Measures

  • Incidence of inappropriate mode switch (documented by stored EGM’s) using the atrial lead Tendril 1699T with short post ventricular atrial blanking period (PVAB) compared to standard atrial lead (Tentril 1388 or 1688) with optimised PVAB
    • Time Frame: 1 and 3 months post implantation

Secondary Measures

  • Incidence of inappropriate mode switch in respect to lead position and ventricular stimulation frequency
    • Time Frame: 1 and 3 months post implantation
  • Atrial Flutter in stored EGM’s
    • Time Frame: 1 and 3 months post implantation
  • 2:1 lock in of Atrial Flutter
    • Time Frame: 1 and 3 months post implantation

Participating in This Clinical Trial

Inclusion Criteria

  • Indication for dual chamber pacing – Implantation of an Identity (ADX) DR or Victory or later pacemaker (St. Jude Medical) – Bipolar atrial pacing electrode – Age >= 18 years Exclusion Criteria:

  • Persistent / permanent Atrial Arrhythmia – Pacemaker Revision – Pregnancy – Participation in another Study involving active implantable medical devices – Unable to complete follow up – Missing patient informed consent – Cardiac surgery or myocardial infarction within the last 4 weeks – Planned cardiac surgery within 3 months after enrollment

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Abbott Medical Devices
  • Provider of Information About this Clinical Study
    • Jörg Scheiner, St. Jude Medical GmbH
  • Overall Official(s)
    • Christof Kolb, MD, Principal Investigator, Deutsches Herzzentrum Muenchen

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