Related Experiment Videos
Influence of autothreshold sensing and sinus rate on mode switching algorithm behavior
M A Wood1, K A Ellenbogen, D Dinsmoor
1Virginia Commonwealth University/Medical College of Virginia, Richmond 23298-0053, USA.
Pacing and Clinical Electrophysiology : PACE
|November 4, 2000
Summary
Mode switching algorithms and atrial sensing impact pacemaker performance in atrial tachyarrhythmias. The Kappa 700 demonstrated superior mode switching, while sinus rates influenced response times.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Mode switching is crucial for managing paroxysmal atrial tachyarrhythmias in pacemaker patients.
- The effectiveness of mode switching depends on algorithms and atrial sensing capabilities.
- Optimal mode switching strategies are still under development.
Purpose of the Study:
- To compare the mode switching behavior of four Medtronic implantable devices.
- To evaluate the influence of different mode switching algorithms and atrial sensing circuits on device performance.
- To assess the impact of simulated atrial fibrillation episodes on device response.
Main Methods:
- Comparative analysis of four Medtronic pacemaker models (Thera DR, Kappa 700, Gem DR, Jewel AF).
- Simulation of 52 human atrial fibrillation episodes using digitally recorded atrial electrograms.
- Testing devices with varying simulated sinus rates before and after atrial fibrillation events.
Main Results:
- The Kappa 700 exhibited the highest appropriate mode switching (94%), while the Thera had the lowest (85%).
- Thera and Gem DR showed significantly longer mode switching times compared to Kappa 700 and Jewel AF.
- Autothreshold atrial sensing (Gem DR) resulted in faster mode switching than fixed gain sensing (Thera).
Conclusions:
- Pacemaker mode switching efficacy is significantly influenced by the specific algorithm and atrial sensing circuitry employed.
- Autothreshold atrial sensing and algorithm choice are key determinants of mode switching response time.
- Pre- and post-episode sinus rates critically affect mode switching and resynchronization times in devices utilizing mean atrial interval algorithms.