Electrocardiographic predictors of atrial mechanical sensing in patients with leadless VDD pacemakers

Abstract Funding Acknowledgements Type of funding sources: None. Background Leadless pacemakers (LP) capable VDD function are a cornerstone modern pacemaker therapy reducing complications in elderly patients while enabling atrioventricular synchrony through mechanical sensing atrial contraction. Because is less reliable than electrical sensing, the reliability LP varies. We evaluated p-wave amplitude from patient ECGs as predictor for successful LP. Materials and methods Consecutive undergoing implantation were included this multi-center retrospective cohort study. As mainly dependent on A4 signal current generation device, ECG parameters pre-implantation separately combination association with post-implantation. Results 122 Patients (mean age 81, female 44%, mean BMI 25.9 kg/m2) included. Main indication was AV-Block (70%). BMI-adjusted P-wave demonstrated statistically significant positive correlation leads I, II, aVL, aVF, aVR, V1 V2 (all p<0.05). A at least 0.1mV had specificity 72% (95%-CI 50%-89%) good signal. sum 0.2mV amplitudes aVL predicts 83% 67-100%) Conclusions selected can predict therefore