Vp suppression algorithm and second degree AV block
Tracing
Manufacturer Biotronik
Device PM
Field Pacing Modes
N° 2
Patient
- 72-year-old man
- Evia DR-T pacemaker (Biotronik) for paroxysmal atrioventricular block
- Vp-suppression algorithm
Graph and trace
- Spontaneous atrial and ventricular rhythm
- First dropped P wave
- Second dropped P wave
- Third dropped P wave
- Switch to DDD mode (second degree AV block)
Comments
- The tracing shows a switch from AAI to DDD for paroxysmal second degree AV block
- There are 4 switching criteria from AAI to DDD corresponding to the different degrees of atrioventricular block
- First-degree AV block criterion: the pacemaker switches to DDD mode when 2 consecutive atrial events (spontaneous or paced) are conducted with an AS-VS or AP-VS delay exceeding 450 ms (non programmable)
- Second-degree AV block criterion: the pacemaker switches to DDD mode when X out of 8 atrial events are dropped; this is the only programmable parameter (1/8, 2/8, 3/8, 4/8)
- Third-degree AV block criterion: the pacemaker switches to DDD mode when 2 (non programmable) consecutive spontaneous or paced atrial activities are dropped
- Pause criterion: the pacemaker switches to DDD mode when the interval between 2 sensed ventricular activations exceeds 2 seconds (non programmable)
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