Document Detail


P-wave locking in the postventricular atrial refractory period of cardiac resynchronization devices : Management with the Biotronik system.
MedLine Citation:
PMID:  22527755     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Electrical desynchronization in cardiac resynchronization therapy (CRT) occurs when sinus P waves are continually locked in the postventricular atrial refractory period (PVARP). This process is characterized by sequences of a P wave as an atrial event in the PVARP followed by a conducted and sensed ventricular event. Such sequences are more common in patients with a prolonged PR interval, often initiated by premature ventricular complexes (PVC) and terminated by PVCs or slowing of the sinus rate. Specific algorithms automatically identify a recurring pattern of P wave locking in the PVARP, whereupon they shorten the PVARP temporarily until atrial tracking is restored with the programmed sensed AV interval. The Biotronik family of Lumax CRT devices use an AV control window which is not an algorithm that "unlocks" P waves trapped in the PVARP. Rather, it prevents P waves from becoming trapped in the PVARP. A ventricular sensed event occurring within the AV control interval does not start a PVARP so that P wave locking cannot occur when the AV conduction time is shorter than the AV control interval.
Authors:
S S Barold; R X Stroobandt; B Herweg; A Kucher
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-13
Journal Detail:
Title:  Herzschrittmachertherapie & Elektrophysiologie     Volume:  -     ISSN:  1435-1544     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9425873     Medline TA:  Herzschrittmacherther Elektrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Florida Heart Rhythm Institute, Tampa General Circle, 33606, Tampa, FL, USA, ssbarold@aol.com.
Vernacular Title:
"P wave locking" in der postventrikulären atrialen Refraktärzeit bei kardialen Resynchronisationsgeräten : Management mit dem Biotronik-System.
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