Alain Ripart

Preliminary clinical experience with the first dual chamber pacemaker defibrillator.

The lack of specificity of VT detection is a significant shortcoming of current ICDs. In a French multicenter study, 18 patients underwent implantation of the Defender 9001 (ELA Medical), an ICD utilizing dual chamber pacing and arrhythmia detection. Over a mean follow‐up period of 7.1 ± 4.5 months, 176 tachycardia episodes recorded in the device memory were analyzed, and physician diagnosis was compared with that by the device. All 122 VT/VF episodes were correctly diagnosed, as were 51 of 53 supraventricular tachyarrhythmias. Two episodes of AF with rapid regular ventricular rates were treated as VT, and a third episode, treated as VT, could not be diagnosed with certainty. A dual chamber pacemaker defibrillator offers improved diagnostic specificity without loss of sensitivity, in addition to the hemodynamic benefit of dual chamber pacing. (PACE 1997;20

Electrode‐Heart Interface: Definition of the Ideal Electrode

Dans la stimulation à deux chambres, pour garder aux stimulateurs leurs avantages de petite taille, de volume réduit et de longue durée, il est nécessaire de diminuer les seuils de stimulation. Ceci peut être accompli par ľoptimisation de ľinterface électrode‐coeur. Des nouvelles électrodes pourraient réquire les pertes de polarisation; de même, des nouveaux matériaux pourraient être envisagés. Les résultats de ces données doivent être rapportés à stimulation chronique.

AAIsafeR limits ventricular pacing in unselected patients.

Introduction: Dedicated pacing modes, such as AAIsafeR, prevent ventricular (V) pacing in selected patients. We report our experience in consecutive unselected patients.

Clinical Results of Low Energy Unipolar or Bipolar Activated Carbon Tip Leads

Biocompatibility of carbon makes it a good candidate for a pacing electrode. Moreover, activation of the electrode creates microporosity, which increases the surface area and reduces polarization losses. Chronic thresholds noninvasively measured on a large population of patients implanted with vitreous carbon electrodes of one manufacturer are significantly lower than those caused by polished platinum tip electrodes of the same manufacturer with similar electrode design.