Acute evaluation of a preformed single-pass VDD/DDD pacing lead

The clinical utility of single lead, atrial synchronous, ventricular pacing (VDD), for patients with normal sinus function and heart block is well established. Atrial stimulation, unavailable in VDD systems presents a significant disadvantage. DDD pacing systems however, require the introduction and positioning of two separate leads. The acute human study discussed evaluated a modified version of a commercially available VDD lead with a preshaped lobe, capable of both sensing and pacing the right atrium. "P" waves and atrial stimulation thresholds were determined in five patients. The mean P-wave was 2.5 +/- 1 millivolts. Atrial stimulation in the unipolar configuration was 1.6 +/- 0.5 volts and 1.7 +/- 0.9 volts in the bipolar configuration. These acute stimulation thresholds and sensing amplitudes were comparable to conventional DDD pacing systems. Therefore, single-lead DDD pacing may be feasible and warrants further study.