Sensing Properties of Pacemaker Leads
Werner E. Irnich · Pacing and Clinical Electrophysiology · 1986
It is already general practice to attribute sensing properties to geometry and surface structure of pacemaker leads. We have to analyze critically whether claims of having found leads with high sensitivity are in accordance with experimental and theoretical findings. From a model can be derived what kind of typical signal structure will originate from an electrode when an excitation wave crosses it, and what of this signal is influenced by electrode parameters. With decreasing surface area, the frequency content of the signal, the impedance, and, theoretically, the amplitude, increases. If the pacemaker characteristics are not matched to the lead properties, this inverse relationship becomes a direct one: If the input impedance is too low or the upper cut-off frequency of the bandpass is not high enough, the effective heart signal seems to be diminished with decreasing size. This, however, is more a pulse generator than a lead problem. If all pacers would possess an input impedance of greater than or equal to 100 K omega and an upper cut-off frequency of greater than or equal to 350 Hz, an attenuation of the heart signal would be less than or equal to 10% and thus, the results with different leads would be very similar and of equally high sensitivity.