ArticleHeart rhythm O22025
Simple electrocardiographic index for A4-wave amplitude of the VDD leadless pacemaker.
Article in Heart rhythm O2, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: A4-wave amplitude (A4-amplitude) is a crucial factor determining the percentage of atrioventricular synchrony (%AVS) in a mechanical sensing-based VDD leadless pacemaker (VDD-LP). We hypothesized that 12-lead electrocardiographic (ECG) parameters related to right atrial (RA) excitation could predict A4-amplitude. Objectives: We aimed to investigate the relationship between A4-amplitude and 12-lead ECG parameters reflecting RA excitation and assess its predictive power for achieving an appropriate A4-amplitude associated with high %AVS. Methods: This single-center, retrospective, observational study enrolled consecutive patients undergoing VDD-LP implantation. The relationship between A4-amplitude and the positive peak amplitude of the P wave in lead II (P2), the positive peak amplitude of the P wave in lead V Results: Of the 67 patients undergoing VDD-LP implantation, 46 without atrial fibrillation bradycardia were enrolled. They had a data set of manual atrial mechanical sensing tests and 12-lead ECG. Among P2, V1P, and V1PP2, only V1PP2 was correlated with A4-amplitude ( Conclusion: V1PP2, reflecting RA excitation, was related to A4-amplitude and had moderate predictive power. Notably, its predictive power increased when limited to patients without sick sinus syndrome. V1PP2 is a simple ECG predictor of A4-amplitude.
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