Comparison of P wave durations as assessed with the bipolar and unipolar atrial intracardiac electrograms: Applicability to quickOpt™

Abstract

Studies have shown that inter-atrial conduction time (IACT) can be used to estimate optimal PV delays. QuickOpt utilizes the atrial EGM (AEGM) and measures P-wave duration (PW) to estimate the IACT. This study compares PW between bipolar (Bi) and unipolar (Uni) AEGMs in patients with either a pacemaker (PP) or a CRT-D pulse generator. Bipolar (Bi) and Unipolar (Uni) AEGMs were obtained from 42 PP and 18 CRT-D pts. In the PP, PWs associated with Bi and Uni AEGMs were close (114±19 ms vs. 110±20 ms). Intra-patient difference was 3.9±8.7 ms, and the 95% confidence interval for the difference was (1.2, 6.6). With CRT-D, PWs were 79±18.4 ms and 81±14 ms for Bi and Uni sensing and the intra-patient difference was -1.2±14.9 ms. In 18 PP, the difference between ECG and either bipolar or unipolar PW was 4.8±17.8 ms and 0.9 ms ± 15.5 ms respectively. PWs were similar between unipolar AEGMs, bipolar AEGMs, and surface ECG.