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Related Experiment Videos

Reduction of right ventricular pacing in patients with sinus node dysfunction using an enhanced search AV algorithm.

Christoph Melzer1, Sameh Sowelam, Todd J Sheldon

  • 1Humboldt-Universität, Charité Hospital, Schumannstrasse 20/21, 10117 Berlin, Germany.

Pacing and Clinical Electrophysiology : PACE
|June 16, 2005
PubMed
Summary

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Extending AV interval parameters beyond 300 ms with the Enhanced Search AV (ESAV) algorithm significantly reduces right ventricular (RV) pacing in patients with intact AV conduction. This pacing optimization improves outcomes for bradycardia patients.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Background:

  • Dual chamber pacing often leads to high ventricular pacing percentages.
  • Long-term right ventricular (RV) pacing may cause detrimental ventricular desynchronization.
  • Current pacemaker algorithms to reduce ventricular pacing are limited by short AV intervals (below 250 ms).

Purpose of the Study:

  • To test the hypothesis that extending AV intervals beyond 300 ms can significantly reduce RV pacing.
  • To evaluate the efficacy of the Enhanced Search AV (ESAV) algorithm in reducing ventricular pacing.

Main Methods:

  • 30 patients with bradycardia indications and Medtronic Kappa 700 pacemakers were randomized.
  • Patients received 2-week treatments with either default Search AV (KSAV) or Enhanced Search AV (ESAV) parameters.

Related Experiment Videos

  • The ESAV algorithm allowed continuous AV delay adjustment and auto-disabling in persistent AV block.

    • Main Results:

    • Patients with intact AV conduction showed significantly lower ventricular pacing (VP) with ESAV (19% +/- 28%) versus KSAV (70% +/- 40%).
    • In patients with persistent AV block, ESAV appropriately suspended, with no significant change in VP.
    • 18 out of 22 patients achieved <40% VP using ESAV.

    Conclusions:

    • Allowing AV interval parameters to extend beyond 300 ms via the ESAV algorithm substantially reduces ventricular pacing.
    • ESAV effectively managed patients with AV block by suspending and reverting to nominal settings.