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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
PubMed
Summary
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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).

Related Experiment Videos

  • 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.