These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Differentiating pacemaker-mediated tachycardia from tachycardia due to atrial tracking: utility of V-A-A-V versus V-A-V response after postventricular atrial refractory period extension.
    Author: Ip JE, Markowitz SM, Liu CF, Cheung JW, Thomas G, Lerman BB.
    Journal: Heart Rhythm; 2011 Aug; 8(8):1185-91. PubMed ID: 21376834.
    Abstract:
    BACKGROUND: Dual-chamber pacemaker systems can lead to two forms of pacemaker-facilitated tachycardia: pacemaker-mediated tachycardia (PMT) and tracking of sinus or atrial tachycardia. Current pacemaker algorithms cannot always differentiate between these two tachycardias. OBJECTIVE: The purpose of this study was to investigate a novel algorithm for distinguishing the two mechanisms of pacemaker-facilitated tachycardia, which is based on the specific termination response to postventricular atrial refractory period (PVARP) extension. METHODS: We prospectively tested our algorithm using the Medtronic Virtual Interactive patient (VIP) II simulator (version 1.53) and a Medtronic Adapta ADDR01 dual-chamber pacemaker. RESULTS: Thirty-five scenarios that triggered "PMT detection" by the device were evaluated. All 12 scenarios of atrial tachycardias with intact AV conduction terminated with a Vp-Ar-Vs (V-A-V) response as a result of PVARP extension. Of the 11 scenarios of atrial tachycardia with complete heart block, all terminated with a Vp-Ar-As-Vp response. All four episodes of PMT with intact AV conduction terminated with a Vp-Ar-As-Vs (V-A-A-Vs) response. Of the eight episodes of PMT with complete heart block, all terminated with a Vp-Ar-As-Vp response. CONCLUSION: In the presence of intact AV conduction, the V-A-V response to PVARP extension is specific to atrial (or sinus) tachycardia, whereas the V-A-A-Vs response is specific to PMT. Recognizing the difference between the two forms of pacemaker-facilitated tachycardias has important implications for pacemaker programming.
    [Abstract] [Full Text] [Related] [New Search]