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Related Experiment Videos

An optimized AV delay algorithm for patients with intermittent atrioventricular conduction

U Stierle1, D Krüger, A M Vincent

  • 1Curschmann-Klinik, Timmendorfer Strand, Germany.

Pacing and Clinical Electrophysiology : PACE
|May 30, 1998
PubMed
Summary
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An AV delay hysteresis algorithm in dual chamber pacemakers effectively promotes natural heart rhythm and reduces ventricular pacing by up to 90%. This promotes physiological activation and conserves pacemaker power in patients with intermittent heart block.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Intermittent atrioventricular (AV) conduction is a challenge in dual chamber pacemaker (DDD) pacing.
  • Current pacing strategies may lead to unnecessary ventricular stimulation, impacting patient outcomes and device longevity.

Purpose of the Study:

  • To evaluate an AV delay hysteresis algorithm for detecting and promoting intermittent AV conduction in DDD pacing.
  • To assess the algorithm's effectiveness in reducing ventricular pacing and its impact on hemodynamic and electrophysiological parameters.

Main Methods:

  • An AV delay hysteresis algorithm was implemented in DDD pacemakers.
  • The algorithm automatically extends the AV delay following an atrial event if spontaneous AV conduction occurred previously.

Related Experiment Videos

  • An automatic search mode was utilized to detect spontaneous ventricular events during the hysteresis interval.

    • Main Results:

    • The algorithm effectively promoted intermittent AV conduction in 17 patients with intermittent AV block.
    • A significant reduction in ventricular pacing events, up to 90%, was observed.
    • No adverse hemodynamic or electrophysiological changes were reported.

    Conclusions:

    • The AV delay hysteresis algorithm is a satisfactory and effective tool for managing intermittent AV block in DDD pacing.
    • The algorithm promotes a physiological activation sequence and reduces ventricular pacing, leading to potential power consumption benefits.
    • AV hysteresis holds incremental value for future DDD pacing in patients with intermittent complete heart block.