Timing Cycles of Implantable Devices

Doppalapudi, Harish

doi:10.1016/b978-0-323-37804-8.00036-5

Cited by 13 publications

(30 citation statements)

References 77 publications

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“…Any conditions that cause AV dissociation in a patient with VA conduction can trigger RRVAS, in which VA conduction plays a key role. 1 The rest types of PMA dependent on VA conduction in initiating and sustaining include repetitive non-reentrant ventriculoatrial synchrony (RNRVAS) and repetitive non-reentrant ventriculoatrial 1:2 synchrony (RNRVA1:2S), both are characterized by making the retrograde P-wave fall in post-ventricular atrial refractory period (PVARP) and subsequent loss of capture or capture of atrial pacing. 2 In a biventricular pacing system, a relatively short AV interval is commonly programmed to obtain the best left ventricular (LV) pump function by allowing complete activation of ventricles from the bi-ventricular pacing sites, which also prevents the appearance of VA conduction.…”

Section: Discussionmentioning

confidence: 99%

Title: Recurrent pacemaker-mediated arrhythmia with a right bundle branch block pattern in a patient with CRT device

Zhang

Han

Zheng

2022

Preprint

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Indroduction: Under certain conditions, cardiovascular implantable electronic devices can be directly involved in initiating and sustaining pacemaker-mediated arrhythmias (PMA), of which repetitive reentrant ventriculoatrial synchrony (RRVAS) is the most well-known and common type. RRVAS, also known as pacemaker-mediated tachycardia, was commonly secondary to atrioventricular (AV) dissociation and subsequent ventriculoatrial (VA) conduction. RRVAS in a bi-ventricular system is rare due to its less predisposition to the appearance of AV dissociation and subsequent VA conduction, but urgent in its adverse impact on cardiac resynchronization therapy (CRT), which may predispose to exacerbated heart failure. Methods/Results: We present a rare case of recurrent PMA manifested as a right bundle branch block pattern in a patient with CRT device. Notably, most episodes of PMA were triggered by a premature atrial contraction accompanied by the appearance of VA conduction with no prolongation of AV delay. Conclusion: In this study, we have demonstrated the impact of the appearance of VA conduction due to the loss of capture of right ventricular lead and its potential risk for inducing RRVAS in CRT device.

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Section: Discussionmentioning

confidence: 99%

Title: Recurrent pacemaker-mediated arrhythmia with a right bundle branch block pattern in a patient with CRT device

Zhang

Han

Zheng

2022

Preprint

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“…This is also true of single‐chamber devices (RV pacing only) that have an atrial dipole designed only for sensing (DX Technology; BIOTRONIK, Inc.). The upper rate limit (URL) is determined by the total atrial refractory period (TARP) which is the sum of the programmed atrioventricular (AV) delay and the postventricular atrial refractory period (PVARP) 13 . If the intrinsic (sensed) atrial rate exceeds the upper rate limit ventricular pacing will not follow in a 1:1 fashion and, in the absence of intrinsic conduction, there will be some degree of AV block (either pacemaker Wenckebach or 2:1 block).…”

Section: Features Common To All Sensorsmentioning

confidence: 99%

“…Sensor‐driven rate smoothing may help decrease or eliminate pauses associated with high atrial rates. Upon detection of an atrial tachyarrhythmia most devices have dedicated algorithms to enable mode‐switching (conversion to a nontracking mode) to prevent rapid ventricular pacing 13 …”

Section: Features Common To All Sensorsmentioning

confidence: 99%

“…If the intrinsic (sensed) atrial rate exceeds the upper rate limit ventricular pacing will not follow in a 1:1 fashion and, in the absence of intrinsic conduction, there will be some degree of AV block (either pacemaker Wenckebach or 2:1 block). AV block is circumvented through the use of rate‐adaptive AV delay and PVARP which shorten the TARP and facilitate 1:1 conduction 13,14 …”

Section: Features Common To All Sensorsmentioning

confidence: 99%

“…In particular, the AV delay (or AV interval) can be shortened. Modulation of the PVARP assumes that retrograde shortens during exertion 13 …”

Section: Features Common To All Sensorsmentioning

confidence: 99%

See 2 more Smart Citations

Sensors for rate‐adaptive pacing: How they work, strengths, and limitations

Trohman

Huang

Larsen

et al. 2020

Cardiovasc electrophysiol

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Chronotropic incompetence is the inability of the sinus node to increase heart rate commensurate with increased metabolic demand. Cardiac pacing alone may be insufficient to address exercise intolerance, fatigue, dyspnea on exertion, and other symptoms of chronotropic incompetence. Rate‐responsive (adaptive) pacing employs sensors to detect physical or physiological indices and mimic the response of the normal sinus node. This review describes the development, strengths, and limitations of a variety of sensors that have been employed to address chronotropic incompetence. A mini‐tutorial on programming rate‐adaptive parameters is included along with emphasis that patients' lifestyles and underlying medical conditions require careful consideration. In addition, special sensor applications used to respond prophylactically to physiologic signals are detailed and an in‐depth discussion of sensors as a potential aid in heart failure management is provided.

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Pacemaker‐mediated arrhythmias

Alasti

Machado

Rangasamy

et al. 2018

Journal of Arrhythmia

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Pacemakers can be directly involved in initiating or sustaining different forms of arrhythmia. These can cause symptoms such as dyspnea, palpitations, and decompensated heart failure. Early detection of these arrhythmias and optimal pacemaker programming is pivotal. The aim of this review article is to summarize the different types of pacemaker‐mediated arrhythmias, their predisposing factors, and mechanisms of prevention or termination.

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Timing Cycles of Implantable Devices

Cited by 13 publications

References 77 publications

Title: Recurrent pacemaker-mediated arrhythmia with a right bundle branch block pattern in a patient with CRT device

Title: Recurrent pacemaker-mediated arrhythmia with a right bundle branch block pattern in a patient with CRT device

Sensors for rate‐adaptive pacing: How they work, strengths, and limitations

Pacemaker‐mediated arrhythmias

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