Document Detail

Inhibition of ventricular stimulation in patients with dual chamber pacemakers and prolonged AV conduction.
MedLine Citation:
PMID:  10588143     Owner:  NLM     Status:  MEDLINE    
Episodes of repetitive P wave undersensing have been described in dual chamber pacemakers due to automatic extension of the postventricular atrial refractory period (PVARP). Pacemaker stimulation was completely inhibited despite the presence of adequate P waves. This study sought to determine whether cycles of repetitive P wave undersensing occur even in the absence of PVARP extension. Two-hundred fifty-five patients were investigated after DDD or VDD pacemaker implantation for intermittent atrioventricular (AV) block. Forty-six episodes of repetitive atrial undersensing were found during 24-hour Holter ECG in nine patients. Pacemaker syndrome-like symptoms occurred. Episodes were elicited by atrial or ventricular premature contractions when (1) native AV conduction was present but considerably prolonged, (2) intrinsic sinus rate exceeded pacemaker intervention rate, and (3) native AV interval plus PVARP exceeded sinus cycle length. Programming of a particularly short AV interval and PVARP helped to reduce the incidence of repetitive P wave undersensing. Patients with dual chamber devices and prolonged native AV conduction are prone to develop episodes of output inhibition. Standard timing cycles may be inappropriate in these patients.
F Bode; U Wiegand; H A Katus; J Potratz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  22     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1999 Oct 
Date Detail:
Created Date:  2000-02-18     Completed Date:  2000-02-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1425-31     Citation Subset:  IM    
Department of Internal Medicine II, Medical University of Luebeck, Germany.
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MeSH Terms
Atrioventricular Node / physiopathology*
Cardiac Pacing, Artificial / methods
Electrocardiography, Ambulatory
Heart Block / physiopathology,  therapy
Heart Conduction System / physiopathology*
Heart Ventricles / physiopathology*
Pacemaker, Artificial*
Time Factors
Comment In:
Pacing Clin Electrophysiol. 1999 Oct;22(10):1423-4   [PMID:  10588142 ]

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