Document Detail

Sustained inhibition of a DDD pacemaker at rates below the programmed lower rate during automatic PVARP extension.
MedLine Citation:
PMID:  10192862     Owner:  NLM     Status:  MEDLINE    
A patient with a Pacesetter Paragon III DDD pacemaker exhibited sustained pacemaker inhibition at rates below the programmed lower rate during sinus rhythm with marked first degree AV block. In this device, a pacemaker defined ventricular extrasystole initiates automatic extension of the postventricular atrial refractory period to 480 ms and the atrial escape interval to 830 ms regardless of the programmed lower rate. Sustained pacemaker inhibition at rates below the programmed lower rate occurred because the P wave fell continually in the extended postventricular atrial refractory period, and the conducted QRS complex initiated a pacemaker ventricular extrasystole response with atrial escape interval extension. This process continued as long as the P wave stayed within the extended postventricular atrial refractory period, no ventricular extrasystole disrupted the sequence, and the R-R interval of spontaneous beats was shorter than the extended atrial escape interval. Such a pacemaker response should not be misinterpreted as device malfunction.
S S Barold
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  22     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-05-26     Completed Date:  1999-05-26     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:  521-4     Citation Subset:  IM    
Department of Medicine, Genesee Hospital, NY 14607, USA.
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MeSH Terms
Cardiac Pacing, Artificial*
Heart Block / physiopathology,  therapy
Pacemaker, Artificial*

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