Document Detail


Ventriculoatrial conduction in patients with implantable cardioverter defibrillators: implications for tachycardia discrimination by dual chamber sensing.
MedLine Citation:
PMID:  7885939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Incorporation of atrial electrograms in the tachycardia detection algorithm may improve tachyarrhythmia discrimination by ICDs but retrograde ventriculoatrial (VA) conduction over the AV node during ventricular tachyarrhythmia may be problematic. The present study analyzed VA conduction characteristics in 66 ICD patients who had evaluation of the VA conduction system by electrophysiological studies before implant. VA conduction was demonstrated in patients during ventricular decremental stimulation. Forty patients had inducible sustained monomorphic VT. The minimum cycle length maintaining 1:1 VA conduction during ventricular stimulation was longer than the cycle of VT in every patient (496 +/- 100 msec vs 320 +/- 81 msec; P < 0.01). Occasional VA conduction during VT was observed in five patients and one patient had 2:1 VA conduction during induced VT. No patient had 1:1 VA conduction during VT. We conclude that brisk VA conduction is uncommon and 1:1 VA conduction during VT is rare ICD recipients. VA conduction is unlikely to complicate the incorporation of atrial electrograms into tachyarrhythmia detection algorithms.
Authors:
H G Li; R K Thakur; R Yee; G J Klein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  17     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-04-11     Completed Date:  1995-04-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2304-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Western Ontario, London, Canada.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Pacing, Artificial
Defibrillators, Implantable*
Female
Heart Conduction System / physiopathology*
Humans
Male
Middle Aged
Tachycardia, Ventricular / diagnosis,  physiopathology*,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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