Reduction of Right Ventricular Pacing in Patients with Sinus Node Dysfunction Using an Enhanced Search AV Algorithm

Melzer, Christoph; Sowelam, Sameh; Sheldon, Todd; Bondke, Hansjürgen; Baumann, Gert; Combs, Bill; Theres, Heinz

doi:10.1111/j.1540-8159.2005.09470.x

Cited by 29 publications

(19 citation statements)

References 22 publications

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“…Although this study is by no means an exhaustive test of AVH in different heart rate and rhythm conditions, the results, which are consistent with previous clinical findings [10,16], have shown that the efficacy of AVH feature is dependent on the underlying cardiac conditions: whereas it is highly effective to preserve intrinsic AV conduction during minor or moderate 1 st degree AVB, its efficacy is reduced as higher degree AVB develops. For the 2 nd degree AVB, AVH seems more effective for Mobitz I than Mobitz II to promote the intrinsic AV conduction (see Fig.…”

Section: Discussionsupporting

confidence: 91%

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Simulation of AV hysteresis pacing using an integrated dual chamber heart and pacer model

Lian

Garner

Krätschmer

et al. 2009

2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Long term right ventricular apical pacing has been known to have adverse effects in cardiac function. The AV hysteresis (AVH) is a feature existing in many dual-chamber cardiac pacemakers that aims to minimize the right ventricular pacing, but its clinical efficacy remains inconclusive due to conflicting evidence from different studies. We have recently developed a novel integrated dual-chamber heart and pacer (IDHP) model, which can simulate various interactions between intrinsic heart activity and extrinsic cardiac pacing. In this study, we use the IDHP model to simulate various atrio-ventricular (AV) conduction pathologies, and to investigate the effects of an AVH algorithm on reducing right ventricular pacing. Our results show that the efficacy of AVH is dependent on the underlying cardiac conditions. While it can preserve intrinsic conduction during minor or moderate first degree AV block, its efficacy is reduced at higher degree AV block conditions. This pilot study further supports using the IDHP model to design and evaluate more advanced pacemaker algorithms for therapeutic interventions.

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Section: Discussionsupporting

confidence: 91%

“…In other 16 test cases, AVH significantly reduces VP% compared to standard DDD (p<1e-6 for all except for test case 5 where p<0.05). Also note that NM conduction does not guarantee VS (e.g., test cases 15,16,18,20), mainly due to presence of retrograde atrial activations (data now shown).…”

Section: Resultsmentioning

confidence: 84%

Simulation of AV hysteresis pacing using an integrated dual chamber heart and pacer model

Lian

Garner

Krätschmer

et al. 2009

2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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“…Fusion Avoidance has proved very effective in patients with normal AV conduction, 13 but its performance has never been tested in patients with spontaneous or drug‐induced AV conduction prolongation. In fact, spontaneous AV conduction may vary substantially from its median value, thus a 100 ms prolongation is often inadequate to avoid unnecessary ventricular stimulation 14,15 . Automatic intrinsic conduction search provides about 40% ventricular pacing as its “best” performance 14 .…”

Section: Discussionmentioning

confidence: 99%

Automatic Verification of Ventricular Stimulation: Fusion Management Algorithm

Bertini

Biffi

Ziacchi

et al. 2007

Pacing Clinical Electrophis

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“…[6,7] The Identity Adx DDD 5286, a product of St. jude's dual chamber pacemaker, can actively prolong VA interval, that is, AF with automatic search function search for sinus rhythm. If the sinus rhythm is detected, the VA interval will work with the programmed frequency.…”

Section: Discussionmentioning

confidence: 99%

Recent impact study of automatic search function of the pacemaker atrial hysteresis on atrial arrhythmias

Zhang

Hui-hua

2016

DCC

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Objective: To explore the recent influences of pacemaker with automatic search function of atrial hysteresis on atrial arrhythmias, and to evaluate it clinical efficacy and safety. Methods: Indentify ADx DDD 5286 implanted dual chamber pacemaker for sick sinus syndrome in 43 cases. Automatic search of atrial lag was not opened with after pacemaker implantation, and the pacemaker settings were kept. Follow-up program after 3 months, DDD mode with automatic search of atrial lag was opened, and this mode was followed up for 6 months, comparing the atrial pacing percentage and DCG atrial tachyarrhythmias of pacemaker implantation to opening atrium lag mode. Results: Compared with the preoperative and operative 3 months later, dynamic electrocardiogram (DCG) 24 h showed that the number of atrial premature beats (APB) and atrial tachycardia, atrial fibrillation (AF) array increased (p < .05); the cases of APB, atrial tachycardia and AF episodes were also increased (p < . In recent years, physicians in the field of pacemaker and electrophysiology have focused their attention on the study of apex pacing of the right ventricle and different ventricular pacing sites.[1] In fact, the right atrial appendage is also a non physiological part of the pacing. The pacing at the same site can also cause abnormal electrical activity of the heart, resulting in the asynchrony of the left and right atrial and their chambers, promoting the reentry of the atrium, and easily inducing reentrant atrial arrhythmias. Secondly, the unnecessary atrial pacing obviously increases the energy consumption. [2,3] Therefore, it is of great significance to reduce the ratio of atrial pacing in clinic. Automatic search of atrial lag can initiatively extend the AA interval regularly, and encourage the occurrence of sinus rhythm, so as to further reduce the purpose of atrial pacing. The paper aims to explore the recent influences of pacemaker with automatic search function of atrial hysteresis on atrial arrhythmias, and to evaluate its clinical efficacy and safety.

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Reduction of Right Ventricular Pacing in Patients with Sinus Node Dysfunction Using an Enhanced Search AV Algorithm

Abstract: Substantial reduction in ventricular pacing can be achieved by allowing the AV interval parameters to extend beyond 300 ms using the ESAV algorithm. In patients with AV block, ESAV suspended and patients were paced at their nominal settings.

Cited by 29 publications

References 22 publications

Simulation of AV hysteresis pacing using an integrated dual chamber heart and pacer model

Simulation of AV hysteresis pacing using an integrated dual chamber heart and pacer model

Automatic Verification of Ventricular Stimulation: Fusion Management Algorithm

Recent impact study of automatic search function of the pacemaker atrial hysteresis on atrial arrhythmias

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