Behavior of AV synchrony pacing mode in a leadless pacemaker during variable AV conduction and arrhythmias
| Autor: | Clemens Steinwender, Surinder Kaur Khelae, Todd J. Sheldon, Larry A. Chinitz, Venkata Sagi, Jens Brock Johansen, Vincent E. Splett, Lluís Mont, Joseph Y.S. Chan, Philippe Ritter, Laurence M. Epstein, Kurt Stromberg, Nina Kristiansen, Rik Willems, Jonathan P. Piccini, Mario Pascual, Christophe Garweg |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pacemaker
Artificial medicine.medical_specialty Ventricular rate Cardiac & Cardiovascular Systems 030204 cardiovascular system & hematology paroxysmal AV block 03 medical and health sciences 0302 clinical medicine Heart Rate Physiology (medical) Internal medicine Atrial Fibrillation Humans Medicine In patient atrial fibrillation Heart Atria 030212 general & internal medicine cardiovascular diseases Atrioventricular Block Science & Technology leadless pacing business.industry Cardiac Pacing Artificial Switching algorithm Atrial fibrillation Original Articles Atrial arrhythmias medicine.disease Av conduction ATRIAL-FIBRILLATION Vdd pacing Cardiology cardiovascular system Cardiovascular System & Cardiology HEART-FAILURE Original Article Cardiac Pacing Ventricular premature beats IMPLANTATION AV synchrony Cardiology and Cardiovascular Medicine business Life Sciences & Biomedicine arrhythmias |
| Zdroj: | Garweg, C, Khelae, S K, Chan, J Y S, Chinitz, L, Ritter, P, Johansen, J B, Sagi, V, Epstein, L M, Piccini, J P, Pascual, M, Mont, L, Willems, R, Splett, V, Stromberg, K, Sheldon, T, Kristiansen, N & Steinwender, C 2021, ' Behavior of AV synchrony pacing mode in a leadless pacemaker during variable AV conduction and arrhythmias ', Journal of cardiovascular electrophysiology, vol. 32, no. 7, pp. 1947-1957 . https://doi.org/10.1111/jce.15061 Journal of Cardiovascular Electrophysiology |
| DOI: | 10.1111/jce.15061 |
| Popis: | INTRODUCTION: MARVEL 2 assessed the efficacy of mechanical atrial sensing by a ventricular leadless pacemaker, enabling a VDD pacing mode. The behavior of the enhanced MARVEL 2 algorithm during variable atrio-ventricular conduction (AVC) and/or arrhythmias has not been characterized and is the focus of this study. METHODS: Of the 75 patients enrolled in the MARVEL 2 study, 73 had a rhythm assessment and were included in the analysis. The enhanced MARVEL 2 algorithm included a mode-switching algorithm that automatically switches between VDD and ventricular only antibradycardia pacing (VVI)-40 depending upon AVC status. RESULTS: Forty-two patients (58%) had persistent third degree AV block (AVB), 18 (25%) had 1:1 AVC, 5 (7%) had variable AVC status, and 8 (11%) had atrial arrhythmias. Among the 42 patients with persistent third degree AVB, the median ventricular pacing (VP) percentage was 99.9% compared to 0.2% among those with 1:1 AVC. As AVC status changed, the algorithm switched to VDD when the ventricular rate dropped less than 40 bpm. During atrial fibrillation (AF) with ventricular response greater than 40 bpm, VVI-40 mode was maintained. No pauses longer than 1500 ms were observed. Frequent ventricular premature beats reduced the percentage of AV synchrony. During AF, the atrial signal was of low amplitude and there was infrequent sensing. CONCLUSION: The mode switching algorithm reduced VP in patients with 1:1 AVC and appropriately switched to VDD during AV block. No pacing safety issues were observed during arrhythmias. ispartof: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY vol:32 issue:7 pages:1947-1957 ispartof: location:United States status: published |
| Databáze: | OpenAIRE |
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