Circulation, Vol 56, 750-755, Copyright © 1977 by American Heart Association
V DeCaprio, P Hurzeler and S Furman
Simultaneous unipolar and bipolar electrograms were recorded and compared
from 49 pacemaker patients with bipolar endocardial electrodes. Average
bipolar depolarization signal voltage equalled that of unipolar but showed
greater variation. Bipolar and unipolar slew rates were equal in both mean
and variance. The proximal pole voltage had little effect on the bipolar
result in 8% of the cases, tended to cancel the tip voltage in 49% of the
cases and augmented the tip voltage in 43% of the electrograms. The average
bipolar R wave duration was 28% less, the T wave amplitude 34% less, and
the ST-segment elevation 37% less than the unipolar values. By consistently
attenuating the undersirable T waves and ST elevations, while leaving the
depolarization signal unaffected, the bipolar electrode offered the
advantage of a superior signal-to-noise ratio for sensing depolarization.
In one case, however, the bipolar signal was so small as to cause a
clinical sensing failure.
ARTICLES
A comparison of unipolar and bipolar electrograms for cardiac pacemaker sensing
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