The University of Southampton
University of Southampton Institutional Repository

Use of an intracardiac electrogram eliminates the need for a surface ECG during implantable cardioverter-defibrillator follow-up

Michael, Kevin A., Peterson, Brett J., Yue, Arthur M., Wilson, Ryan D., Wang, Li, Ousdigian, Kevin, Wilkoff, Bruce, Sterns, Laurence and Morgan, John M. (2007) Use of an intracardiac electrogram eliminates the need for a surface ECG during implantable cardioverter-defibrillator follow-up Pacing and Clinical Electrophysiology, 30, (12), pp. 1432-1437. (doi:10.1111/j.1540-8159.2007.00888.x).

Record type: Article


BACKGROUND: A surface electrocardiogram (SECG) for pacing threshold measurements during routine implantable cardioverter-defibrillator (ICD) follow-up can be cumbersome. This study evaluated the use of an intrathoracic far-field electrogram (EGM) derived between the Can and superior vena cava (SVC) electrode -- the Leadless electrocardiogram (LLECG), in dual chamber ICDs in performing pacing threshold tests. METHODS: The LLECG was evaluated prospectively during atrial and ventricular pacing threshold testing as a substudy of the Comparison of Empiric to Physician-Tailored Programming of Implantable Cardioverter-Defibrillators trial (EMPIRIC) in which dual chamber ICDs were implanted in 888 patients. Threshold tests were conducted at 1 volt by decrementing the pulse width. Follow-up at three months compared pacing thresholds measured using LLECG with those using Lead I of the surface ECG (SECG). The timesaving afforded by LLECG was assessed by a questionnaire. RESULTS: The median threshold difference between LLECG and SECG measurements for both atrial (0.00 ms, P = 0.90) and ventricular (0.00 ms, P = 0.34) threshold tests were not significant. Ninety percent of atrial and ventricular threshold differences were bounded by +/- 0.10 ms and -0.10 to +0.04 ms, respectively. We found that 99% of atrial and ventricular thresholds tests at six and 12 months attempted using LLECG were successfully completed. The questionnaire indicated that 65% of healthcare professionals found LLECG to afford at least some timesaving during device follow-ups. CONCLUSION: Routine follow-up can be performed reliably and expeditiously in dual chamber Medtronic (Minneapolis, MN, USA) ICDs using LLECG alone, resulting in overall timesaving.

Full text not available from this repository.

More information

Published date: December 2007
Keywords: defibrillation-icd, electrocardiogram, new technology, pacing


Local EPrints ID: 61369
PURE UUID: 4207cfec-ba80-42c2-a58a-b96e5a7cf81c

Catalogue record

Date deposited: 06 Oct 2008
Last modified: 17 Jul 2017 14:22

Export record



Author: Kevin A. Michael
Author: Brett J. Peterson
Author: Arthur M. Yue
Author: Ryan D. Wilson
Author: Li Wang
Author: Kevin Ousdigian
Author: Bruce Wilkoff
Author: Laurence Sterns
Author: John M. Morgan

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.