Adaptive ventricular rate smoothing during atrial fibrillation: a pilot comparison study.

An adaptive ventricular rate smoothing (VRS) algorithm is developed to regularize the ventricular rate during atrial fibrillation (AF) by means of ventricular pacing (VP). Using a quantitative AF-VP model, we conduct pilot study to compare its performance with three other VRS algorithms. Simulations show that all VRS algorithms are effective to stabilize the heart rate during AF when intrinsic ventricular rate is not higher than the maximum pacing rate. The effect of VRS is diminished as the intrinsic ventricular rate increases, whereas slower intrinsic ventricular rate renders more aggressive VP. Compared to other methods, the Adaptive-VRS algorithm tends to stabilize the ventricular rate during AF with less VP, while intrinsic ventricular responses with physiological rate and rhythm are preferably preserved.