An A-V Data Lead System for Electrogram Detection

Some telemetrically monitored pacemakers are capable of detecting and transmitting either the P- or R-wave, however, none are able to transmit the complete electrogram (EGM) during normal and paced rhythms. A new lead system has been developed that, when used in conjunction with a telemetrypacemaker system, permits the transmissionofthe complete EGM and is not adversely affected by pacemaker outputs or afterpotentials. Detecting electrodes are placed in both right atrium and ventricle in order to optimize EGM detection. Electrically separate from the pacing-sensing electrodes, the A-V Data probes are structurally part of a transvenously placed ventricular lead no larger than a conventional bipolar lead (2.3 mm). The EGM telemetry system is also compatible with telephone monitoring systems. The A-V data lead has consistently demonstrated its ability to accurately detect the EGM during normal sinus rhythms as well as during atrial, ventricular, and A-V sequential pacing. In addition, this system can detect and transmit EGM abnormalities such as ectopic beats and retrograde conduction. Eight A-V data lead, telemetry monitored VVI pacemakers have been implanted in dogs for over two years. This system has provided the means to noninvasively detect and telemetrically record the entire normal and abpormal EGM, even in pacer dependent patients.