Arrhythmias & electrophysiology
Electrocardiographic predictors of atrial mechanical sensing in leadless pacemakers
Authors' conclusion
P-wave amplitudes in ECG leads aVL and V1 can predict A4 signal amplitude in patients with VDD LP and therefore the probability of successful AV synchronous pacing.
Study context
- Population
- Consecutive patients undergoing VDD leadless pacemaker implantation61 in A4 signal analysis
- Participants
- 80 patients
- Outcome
- Association of preoperative 12-lead ECG P-wave amplitude in sinus rhythm with atrial mechanical sensing signal amplitude (A4)
Methodological details2-center, consecutive patients, 19 patients in VVI mode during follow-up excluded from A4 analysis
- 2-center
- Consecutive patients
- 19 patients in VVI mode during follow-up excluded from A4 analysis
Main finding
As reported in the abstract
P-wave amplitude vs A4 signal amplitude
- Absolute (aVL, aVF, V1, V2) and BMI-adjusted (I, II, aVL, aVF, aVR, V1, V2) P-wave amplitudes significantly positively correlated with A4 signal amplitude
- all P <.05
- Combined P-wave amplitude ≥0.2 mV in V1 and aVL predictive of A4 signal ≥1 m/s2: specificity
- 83% (95% CI 67%-100%)
Observational data: associations, not effects.
Further findings
- Significant correlation of A4 signal amplitude and overall AV synchrony
- P = 0.013
Original publication
Electrocardiographic predictors of atrial mechanical sensing in leadless pacemakers. Heart Rhythm. Published 1 March 2024. doi:10.
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