Measurement of unipolar paced-evoked potentials

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Measurement of unipolar paced-evoked potentials

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The development of intelligent and adaptive cardiac pacemakers is limited by the absence of a reliable measure of physiological state. Evidence exists to suggest that the required information may be obtained from the paced-evoked cardiac potentials. The most convenient way to measure these potentials, in clinical practice, is to use the existing single unipolar electrode for both stimulation and measurement. Owing to the electrochemistry of the electrode tissue system, an afterpotential exists across the electrodes following the stimulus. This is approximately two orders of magnitude larger than the potential to be measured. The system developed by the authors and described here cancels the after-potential in a novel, quasi-closed-loop, adaptive manner. The designs of the system and the electronic circuitry are described. Several sets of equipment have been constructed and used by the authors, and others, for the reliable measurement of the paced evoked cardiac potential.

Inspec keywords: adaptive systems; pacemakers; biomedical measurement; biocontrol; bioelectric potentials; closed loop systems; cardiology

Other keywords: intelligent pacemaker; electrode tissue system; adaptive system; unipolar paced-evoked potentials; quasi-closed-loop; adaptive cardiac pacemakers; electrochemistry; afterpotential; stimulation; measurement

Subjects: Bioelectricity; Self-adjusting control systems; Prosthetics and orthotics; Prosthetic and orthotic control systems; Prosthetics and other practical applications; Electrical activity in neurophysiological processes; Bioelectric signals; Patient diagnostic methods and instrumentation

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      • C. Walton , S. Gergely , A.P. Economides . Platinum pacemaker electrodes: origins and effects of electrode-tissue interface impedance. PACE , 87 - 99
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      • C. Walton , A.P. Economides , S. Gergely , G. Perez . (1985) A new look at the unipolar paced-evoked response, Cardiac pacing.
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      • A.F. Rickards , J. Norman . Relations between qt interval and heart rate. new design of physiologically adaptive cardiac pacemaker. Br. Heart J. , 56 - 61
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