Sami Pakarinen1, Lauri Toivonen. 1. Department of Cardiology, Meilahti Hospital, Helsinki University Central Hospital, Haartmaninkatu 4, P.O. Box 340, 00029 HUS, Helsinki, Finland. sami.pakarinen@hus.fi
Abstract
AIMS: The aim of the study was to evaluate the performance of pacemakers (PM) atrial tachyarrhythmia (AT)-sensing algorithms in sinus node dysfunction (SND) patients with DDDR pacing programmed with a fixed long atrioventricular (AV) delay. METHODS: In a prospective study, a total of 60 patients with SND were implanted with a dual-chamber PM with two different algorithms for detection of ATs. The study was done with a 3 month data collection period retrieved from the memory of PM and with a 7 day external Holter recording period. RESULTS: In 13 of 16 (81 %) patients whose Holter recording revealed the presence of ATs, episodes of AT sensing were retrieved from the PM memory with electrograms verifications, confirming that the devices had detected the ATs. Very short ATs seen in Holter recordings were missed by the PM with three patients. However, with all these patients after 3 months of follow up period, there were recognized periods of ATs by the PM. With ten (17 %) patients, there were intermittent periods of undersensing by the PM although continuous atrial fibrillation (AF) was seen in the Holter recording. Retrograde conduction caused false AT detection due to repetitive non-reentrant ventriculoatrial synchronous rhythm (RNRVAS) in six (25 %) of the 24 patients with retrograde conduction. CONCLUSIONS: Even with long AV delay, ATs can be accurately identified. However, transient undersensing of continuous AF and non-detection of very short AT episodes can still occur. Programming a long AV delay predisposes to RNRVAS which can cause false AT detection and symptoms in SND patients who have retrograde conduction.
AIMS: The aim of the study was to evaluate the performance of pacemakers (PM) atrial tachyarrhythmia (AT)-sensing algorithms in sinus node dysfunction (SND) patients with DDDR pacing programmed with a fixed long atrioventricular (AV) delay. METHODS: In a prospective study, a total of 60 patients with SND were implanted with a dual-chamber PM with two different algorithms for detection of ATs. The study was done with a 3 month data collection period retrieved from the memory of PM and with a 7 day external Holter recording period. RESULTS: In 13 of 16 (81 %) patients whose Holter recording revealed the presence of ATs, episodes of AT sensing were retrieved from the PM memory with electrograms verifications, confirming that the devices had detected the ATs. Very short ATs seen in Holter recordings were missed by the PM with three patients. However, with all these patients after 3 months of follow up period, there were recognized periods of ATs by the PM. With ten (17 %) patients, there were intermittent periods of undersensing by the PM although continuous atrial fibrillation (AF) was seen in the Holter recording. Retrograde conduction caused false AT detection due to repetitive non-reentrant ventriculoatrial synchronous rhythm (RNRVAS) in six (25 %) of the 24 patients with retrograde conduction. CONCLUSIONS: Even with long AV delay, ATs can be accurately identified. However, transient undersensing of continuous AF and non-detection of very short AT episodes can still occur. Programming a long AV delay predisposes to RNRVAS which can cause false AT detection and symptoms in SND patients who have retrograde conduction.
Authors: Panos E Vardas; Angelo Auricchio; Jean-Jacques Blanc; Jean-Claude Daubert; Helmut Drexler; Hugo Ector; Maurizio Gasparini; Cecilia Linde; Francisco Bello Morgado; Ali Oto; Richard Sutton; Maria Trusz-Gluza Journal: Europace Date: 2007-08-28 Impact factor: 5.214
Authors: Willem G de Voogt; Norbert M van Hemel; Arjan A van de Bos; Juhani Koïstinen; Jules H Fast Journal: Europace Date: 2006-11 Impact factor: 5.214
Authors: Michael O Sweeney; Anne S Hellkamp; Kenneth A Ellenbogen; Arnold J Greenspon; Roger A Freedman; Kerry L Lee; Gervasio A Lamas Journal: Circulation Date: 2003-06-02 Impact factor: 29.690