{"id":299,"date":"2025-07-13T09:44:48","date_gmt":"2025-07-13T09:44:48","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=299"},"modified":"2026-06-30T14:18:21","modified_gmt":"2026-06-30T14:18:21","slug":"mode-switch-during-atrial-arrhythmias","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/basic-concepts\/pacemaker\/mode-switch-during-atrial-arrhythmias\/","title":{"rendered":"Repli sur arythmies atriales"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"299\" class=\"elementor elementor-299\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fff9b34 e-con-full e-flex e-con e-parent\" data-id=\"fff9b34\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fc2c360 elementor-widget elementor-widget-heading\" data-id=\"fc2c360\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Mode switch during atrial arrhythmias<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-07c9024 elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"07c9024\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h3&quot;,&quot;h4&quot;,&quot;h5&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;no_headings_message&quot;:&quot;No headings were found on this page.&quot;,&quot;marker_view&quot;:&quot;bullets&quot;,&quot;icon&quot;:{&quot;value&quot;:&quot;fas fa-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;,&quot;rendered_tag&quot;:&quot;&lt;svg class=\\&quot;e-font-icon-svg e-fas-circle\\&quot; viewBox=\\&quot;0 0 512 512\\&quot; xmlns=\\&quot;http:\\\/\\\/www.w3.org\\\/2000\\\/svg\\&quot;&gt;&lt;path d=\\&quot;M256 8C119 8 8 119 8 256s111 248 248 248 248-111 248-248S393 8 256 8z\\&quot;&gt;&lt;\\\/path&gt;&lt;\\\/svg&gt;&quot;},&quot;minimize_box&quot;:&quot;yes&quot;,&quot;minimized_on&quot;:&quot;tablet&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t\t\t\t<h4 class=\"elementor-toc__header-title\">\n\t\t\t\tContent\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__07c9024\" aria-expanded=\"true\" aria-label=\"Ouvrir la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/div>\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__07c9024\" aria-expanded=\"true\" aria-label=\"Fermer la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<div id=\"elementor-toc__07c9024\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-21cd55c elementor-widget elementor-widget-heading\" data-id=\"21cd55c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">General information<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f3f351d e-con-full e-flex e-con e-parent\" data-id=\"f3f351d\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-85854b3 elementor-widget elementor-widget-text-editor\" data-id=\"85854b3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The management of pacemaker patients with atrial arrhythmia episodes is complex, due to the different types of mechanisms known to trigger atrial arrhythmias, and the risk of ventricular pacing running out of control on detection of a rapid atrial rhythm.<\/p><p>Detection of atrial arrhythmias is an ongoing process in which the device analyzes the atrial rate and its effect on the ventricular rhythm. The stimulator automatically records diagnostic data on the various arrhythmia episodes, which can help in the management of these patients and in any therapeutic adaptation.<\/p><p>The device can be programmed to respond to an atrial arrhythmia by switching to an asynchronous mode, to avoid high-frequency ventricular pacing that could compromise hemodynamic stability. Mode switching refers to the pacemaker&#8217;s ability to switch automatically from an atrial tracking mode (DDD or VDD) to a non-atrial tracking mode (DDI or VDI). The ventricular pacing frequency gradually shifts (depending on the manufacturer) from synchronous to tracking frequency. This avoids a sudden drop in ventricular rate. When the atrial tachyarrhythmia ends, mode switching returns to the programmed synchronous pacing mode.<\/p><p>The ideal mode switching algorithm has the following features:<\/p><ul><li>rapid triggering to avoid prolonged rapid ventricular pacing during the initial arrhythmia detection phase<\/li><li>ability to quickly switch back to synchronous mode at the end of the arrhythmia episode<\/li><li>good ability to diagnose atrial arrhythmia even in the presence of atrial signals of variable amplitude and frequency<\/li><li>ability to avoid mode switching in response to cross-talk, noise or sinus tachycardia<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-aa73e98 e-con-full e-flex e-con e-parent\" data-id=\"aa73e98\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cfad410 elementor-widget elementor-widget-heading\" data-id=\"cfad410\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Brand specific information<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5dbe4d7 e-con-full e-flex e-con e-parent\" data-id=\"5dbe4d7\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ad3c7ba elementor-widget elementor-widget-heading\" data-id=\"ad3c7ba\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Abbott<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-01c7a71 e-con-full e-flex e-con e-parent\" data-id=\"01c7a71\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-87ad032 elementor-widget elementor-widget-text-editor\" data-id=\"87ad032\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Mode switching algorithm<\/h6><p>Automatic mode switching (AMS) takes place when the filtered atrial frequency exceeds the atrial tachycardia detection frequency (ATDF).<\/p><p>CAM uses a filtered, rather than instantaneous, atrial rate, based on a comparison of the current atrial rate with a continuously updated average rate, in order to distinguish between sustained tachycardia and rapid intermittent cycles.<\/p><p>When the filtered atrial rate exceeds the programmed FDTA value, the device switches to DDI(R) or VVI(R) mode.<\/p><p>At each cycle, the device measures the instantaneous PP interval.<\/p><p>It calculates a filtered atrial interval (FAI) according to the following rule:<\/p><ul><li>If instantaneous PP \u2264 FAI: FAI decremented by 38 ms<\/li><li>If instantaneous PP &gt; FAI: FAI incremented by 25 ms<\/li><\/ul><p>Mode switching occurs as soon as the filtered atrial interval falls below the atrial tachycardia detection interval.<\/p><p>During mode switching, the pacing frequency corresponds to the AMS base frequency (independently programmable) or to the frequency indicated by the sensor (slaved frequency).<\/p><p>A return to synchronous mode is only possible if the atrial frequency falls below the maximum synchronous frequency (FAI&gt; maximum synchronous frequency interval).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a8a847a elementor-widget elementor-widget-image\" data-id=\"a8a847a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a11-2.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a11 (2)\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxOSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExMS0yLnBuZyJ9\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"526\" height=\"259\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a11-2.png\" class=\"attachment-large size-large wp-image-6719\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a11-2.png 526w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a11-2-300x148.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a11-2-18x9.png 18w\" sizes=\"(max-width: 526px) 100vw, 526px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-28f422f elementor-widget elementor-widget-text-editor\" data-id=\"28f422f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Example: atrial tachycardia detection interval at 180 min-1 \/ 333 ms<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9183e0d elementor-widget elementor-widget-image\" data-id=\"9183e0d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a12-2.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a12 (2)\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxOCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExMi0yLnBuZyJ9\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"551\" height=\"468\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a12-2.png\" class=\"attachment-large size-large wp-image-6718\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a12-2.png 551w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a12-2-300x255.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a12-2-14x12.png 14w\" sizes=\"(max-width: 551px) 100vw, 551px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3c04b9e elementor-widget elementor-widget-text-editor\" data-id=\"3c04b9e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Programming<\/h6>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7a67eec elementor-widget elementor-widget-image\" data-id=\"7a67eec\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a13-2.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a13 (2)\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxNywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExMy0yLnBuZyJ9\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"486\" height=\"222\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a13-2.png\" class=\"attachment-large size-large wp-image-6717\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a13-2.png 486w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a13-2-300x137.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a13-2-18x8.png 18w\" sizes=\"(max-width: 486px) 100vw, 486px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f0aca07 elementor-widget elementor-widget-text-editor\" data-id=\"f0aca07\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Recording a TA\/FA episode<\/span><\/p><p>The criterion for recording AT\/AF episodes is the atrial tachycardia detection interval (ATDI). The calculation method for the filtered atrial interval (FAI) is identical.<\/p><p>To record an episode, 4 consecutive cycles with a PP interval and a FAI that are less than the ATDI are required. These consecutive cycles make it possible to avoid the recording of AMS episodes on cross-listening (alternating short and long cycles which can lead to AMS but not to the recording of the episode because there are no consecutive short cycles). The AMS criterion is more sensitive than the recording criterion, which is more specific. 8 cycles with a PP interval and FAI greater than ATDI are then required for the episode to be completed (2 episodes less than 20 seconds apart are considered a single AT\/AF episode).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-88489e3 e-con-full e-flex e-con e-parent\" data-id=\"88489e3\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c28375a elementor-widget elementor-widget-image\" data-id=\"c28375a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a14-1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a14\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxNiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExNC0xLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"679\" height=\"710\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a14-1.png\" class=\"attachment-large size-large wp-image-6716\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a14-1.png 679w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a14-1-287x300.png 287w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a14-1-11x12.png 11w\" sizes=\"(max-width: 679px) 100vw, 679px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e4e8ca5 elementor-widget elementor-widget-image\" data-id=\"e4e8ca5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a15-1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a15\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxNCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExNS0xLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"671\" height=\"487\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a15-1.png\" class=\"attachment-large size-large wp-image-6714\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a15-1.png 671w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a15-1-300x218.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a15-1-18x12.png 18w\" sizes=\"(max-width: 671px) 100vw, 671px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-89800b6 elementor-widget elementor-widget-text-editor\" data-id=\"89800b6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">AF load<\/span><\/p><p>AT\/AF Load is the percentage of time spent in AT\/AF over a 52-week period. Each data point on the graph corresponds to the percentage of time the patient was in AT\/AF over a seven-day period.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-08c3833 elementor-widget elementor-widget-image\" data-id=\"08c3833\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a16-1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a16\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxNSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExNi0xLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"686\" height=\"347\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a16-1.png\" class=\"attachment-large size-large wp-image-6715\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a16-1.png 686w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a16-1-300x152.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a16-1-18x9.png 18w\" sizes=\"(max-width: 686px) 100vw, 686px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1cbce8f elementor-widget elementor-widget-heading\" data-id=\"1cbce8f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Biotronik<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-18f60fd e-con-full e-flex e-con e-parent\" data-id=\"18f60fd\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-15f645c elementor-widget elementor-widget-text-editor\" data-id=\"15f645c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Programming the mode switch algorithm<\/h6><p>In a Biotronik dual-chamber stimulator, various parameters of the mode switch algorithm can be programmed:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6eeafda elementor-widget elementor-widget-image\" data-id=\"6eeafda\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a1\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyOSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"688\" height=\"611\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a1.png\" class=\"attachment-large size-large wp-image-6729\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a1.png 688w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a1-300x266.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a1-14x12.png 14w\" sizes=\"(max-width: 688px) 100vw, 688px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0e97fbe elementor-widget elementor-widget-text-editor\" data-id=\"0e97fbe\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li>the mode switch algorithm is programmable on or off<\/li><li>the intervention frequency corresponds to the minimum atrial frequency at which the mode switch algorithm is triggered (programmable between 100 and 250 bpm, nominal value 160 bpm)<\/li><li>the &#8220;switch to&#8221; corresponds to the mode in which the pacemaker retreats; it depends on the pacing mode programmed (DDD: DDI or DDIR; DDDR: DDIR; VDD: VDI or VDIR; VDDR : VDIR)<\/li><li>the start-up criterion (synchronous mode to asynchronous mode) uses a rolling window of X (programmable between 3 and 8, nominal value 5) cycles out of 8; X cycles out of 8 faster than the intervention frequency are therefore required to switch to asynchronous mode; the value 5 out of 8 avoids unnecessary mode oscillations in the event of atrial extrasystoles or unstable atrial signals; similarly, it avoids inappropriate cross-listening switching when the heart rate is not fast (1 cycle out of 2 fast : 4\/8)<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a8fceb6 elementor-widget elementor-widget-image\" data-id=\"a8fceb6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a2.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a2\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyOCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EyLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"549\" height=\"315\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a2.png\" class=\"attachment-large size-large wp-image-6728\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a2.png 549w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a2-300x172.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a2-18x10.png 18w\" sizes=\"(max-width: 549px) 100vw, 549px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bda42d1 elementor-widget elementor-widget-text-editor\" data-id=\"bda42d1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li>the stop criterion (asynchronous mode to synchronous mode) uses a rolling window of X (programmable between 3 and 8, nominal value 5) cycles out of 8; X cycles out of 8 slower than the intervention frequency are therefore required to return to synchronous mode<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9f15d5e elementor-widget elementor-widget-image\" data-id=\"9f15d5e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a3.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a3\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyNywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EzLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"538\" height=\"304\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a3.png\" class=\"attachment-large size-large wp-image-6727\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a3.png 538w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a3-300x170.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a3-18x10.png 18w\" sizes=\"(max-width: 538px) 100vw, 538px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c7357eb elementor-widget elementor-widget-text-editor\" data-id=\"c7357eb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li>modification of basal rate: a higher basal rate (programmable between 0 and 30 bpm faster, nominal value 10 bpm) can be set during mode switching to alleviate the adverse hemodynamic conditions associated with atrial arrhythmia<\/li><\/ul><h6>Querying statistics in device memories<\/h6><p><span style=\"text-decoration: underline;\">AF load<\/span><\/p><p>AF load is the percentage of time the patient is in AF over the course of a day. The device records the number and duration of atrial arrhythmia episodes per day for the 240 days preceding the query. For the device to record an episode, the fast atrial rate parameter must be on, and the criterion 36 events out of 48 fast cycles (faster than the programmed atrial rate) must be met.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0e54248 elementor-widget elementor-widget-image\" data-id=\"0e54248\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a4.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a4\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyNiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2E0LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"426\" height=\"326\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a4.png\" class=\"attachment-large size-large wp-image-6726\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a4.png 426w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a4-300x230.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a4-16x12.png 16w\" sizes=\"(max-width: 426px) 100vw, 426px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eb8c679 elementor-widget elementor-widget-text-editor\" data-id=\"eb8c679\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Episode timing<\/span><\/p><p>The device divides the day into 3-hour blocks to determine the start time of atrial arrhythmia episodes.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5304320 elementor-widget elementor-widget-image\" data-id=\"5304320\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a5.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a5\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyNSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2E1LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"473\" height=\"358\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a5.png\" class=\"attachment-large size-large wp-image-6725\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a5.png 473w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a5-300x227.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a5-16x12.png 16w\" sizes=\"(max-width: 473px) 100vw, 473px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ea73bcc elementor-widget elementor-widget-text-editor\" data-id=\"ea73bcc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Number of mode switches<\/span><\/p><p>The device provides the number of mode switch episodes.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8b28442 elementor-widget elementor-widget-image\" data-id=\"8b28442\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a6.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a6\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyNCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2E2LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"436\" height=\"330\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a6.png\" class=\"attachment-large size-large wp-image-6724\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a6.png 436w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a6-300x227.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a6-16x12.png 16w\" sizes=\"(max-width: 436px) 100vw, 436px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d695565 e-con-full e-flex e-con e-parent\" data-id=\"d695565\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9040ecd elementor-widget elementor-widget-heading\" data-id=\"9040ecd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Boston Scientific<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-54811dd e-con-full e-flex e-con e-parent\" data-id=\"54811dd\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8c604a4 elementor-widget elementor-widget-text-editor\" data-id=\"8c604a4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>How the mode switch algorithm works<\/h6>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-82d7b19 elementor-widget elementor-widget-image\" data-id=\"82d7b19\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a7.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a7\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyMywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2E3LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"547\" height=\"304\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a7.png\" class=\"attachment-large size-large wp-image-6723\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a7.png 547w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a7-300x167.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a7-18x10.png 18w\" sizes=\"(max-width: 547px) 100vw, 547px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f41bf55 elementor-widget elementor-widget-text-editor\" data-id=\"f41bf55\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ul><li>first step: the atrial tachycardia rate is exceeded; atrial events classified as AS or in refractory period (PVARP) are included in the atrial rate calculation, unlike cycles in blankings or noise windows, which are excluded.<\/li><li>second step: the input counter is completed; this counter corresponds to a number of atrial cycles faster than the fallback rate; this counter is incremented by 1 (+1) for each cycle faster than the fallback rate and decremented by 1 (-1) for each cycle detected or stimulated that is slower. When the counter is complete, the duration starts.<\/li><li>third step: the duration criterion is met; the duration corresponds to the number of cycles during which the arrhythmia must persist before the mode switchover.<\/li><li>fourth step: mode switchover to an asynchronous mode; this switchover starts at the end of the duration and persists until the output counter reaches 0.<\/li><li>fifth step: progressive decrease in ventricular stimulation frequency; the stimulation frequency gradually decreases to reach either the programmed minimum fallback frequency or the servo frequency.<\/li><li>sixth step: the output counter is completed; this counter counts atrial cycles slower than the programmed fallback frequency and starts at the time of duration; this counter is incremented by 1 (+1) for each cycle faster than or equal to the fallback frequency and decremented by 1 (-1) for each cycle detected or stimulated that is slower. If this counter reaches 0 during the duration, there is no mode switching; if this counter reaches 0 after mode switching, the device switches to a synchronous mode.<\/li><\/ul><h6>Programmable parameters<\/h6><ul><li>the RTA trigger frequency corresponds to the frequency at which the device begins to detect atrial tachycardias;<\/li><li>the input counter corresponds to the number of detected fast atrial events required to satisfy initial detection and activate the duration and output counter;<\/li><li>the RTA duration corresponds to the number of ventricular cycles during which atrial events continue to be evaluated after initial detection; if BP persists during the duration, mode switching occurs;<\/li><li>the fallback time controls how quickly the stimulated rate decreases during fallback to the minimum fallback rate or sensor rate;<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8136449 elementor-widget elementor-widget-image\" data-id=\"8136449\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a8.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a8\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyMiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2E4LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"694\" height=\"441\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a8.png\" class=\"attachment-large size-large wp-image-6722\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a8.png 694w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a8-300x191.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a8-18x12.png 18w\" sizes=\"(max-width: 694px) 100vw, 694px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-783e1c1 e-con-full e-flex e-con e-parent\" data-id=\"783e1c1\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-40c9afc elementor-widget elementor-widget-heading\" data-id=\"40c9afc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Medtronic<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f7fcd98 e-con-full e-flex e-con e-parent\" data-id=\"f7fcd98\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f3b5c4b elementor-widget elementor-widget-text-editor\" data-id=\"f3b5c4b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Asynchronous mode switching (new pacemaker platform)<\/h6><p>The pacemaker switches to DDIR mode (non-programmable mode) when the criterion for sudden onset of AT\/AF is met, if the median value of the 12 most recent detected atrial intervals is shorter than the programmed AT\/AF interval, and if the AF evidence counter (2 atrial signals detected between 2 ventricular signals) is greater than or equal to 3. To avoid an abrupt drop in ventricular rate, it very gradually reduces the pacing frequency from the synchronous atrial rate to that indicated by the sensor over several pacing cycles. Event markers include an \u201cMS\u201d marker for each mode switch, whether to asynchronous or synchronous mode.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d4f23aa elementor-widget elementor-widget-image\" data-id=\"d4f23aa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a9.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a9\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyMSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2E5LnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"713\" height=\"212\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a9.png\" class=\"attachment-large size-large wp-image-6721\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a9.png 713w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a9-300x89.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a9-18x5.png 18w\" sizes=\"(max-width: 713px) 100vw, 713px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-30d2237 elementor-widget elementor-widget-text-editor\" data-id=\"30d2237\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ol><li>Onset of atrial arrhythmia with acceleration of stimulated ventricular rate<\/li><li>Criterion for abrupt onset of AT\/AF is met; MS (mode switch) marks transition to fallback; programmed pacing mode changes to DDIR mode<\/li><li>Progressive transition from rapid ventricular pacing rate to servo rate (+ 40 ms at each interval)<\/li><li>End of arrhythmia ; return to programmed mode (except for MVP mode, for which there is always a return to DDD before a return to AAI)<\/li><\/ol><h6>Switch to synchronous atrial tracking mode (new pacemaker platform)<\/h6><p>The episode is stopped if a normal sinus rhythm (or normal stimulated rhythm) is identified for 5 consecutive ventricular intervals, or if the median atrial interval is greater than the AT\/AF detection interval, or if the AT\/AF counter is less than 27 for 3 minutes.<\/p><h6>Memorization of atrial arrhythmia episodes<\/h6><p>Pathological atrial events are memorized when they have generated a fold. It is possible to view the graph, EGMs and summary text for different recorded episodes.<\/p><p>The cardiac monitor report provides information on AT\/AF\u00a0episodes and ventricular rhythms, indicates the time spent in AT\/AF, and provides information on the evolution of total AT\/AF\u00a0hours per day (graph).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aaac461 elementor-widget elementor-widget-image\" data-id=\"aaac461\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a10.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a10\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcyMCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExMC5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"473\" height=\"340\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a10.png\" class=\"attachment-large size-large wp-image-6720\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a10.png 473w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a10-300x216.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a10-18x12.png 18w\" sizes=\"(max-width: 473px) 100vw, 473px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3b67312 e-con-full e-flex e-con e-parent\" data-id=\"3b67312\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a766d27 elementor-widget elementor-widget-heading\" data-id=\"a766d27\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Microport<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e48bd3c e-con-full e-flex e-con e-parent\" data-id=\"e48bd3c\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e89f2e6 elementor-widget elementor-widget-text-editor\" data-id=\"e89f2e6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Principle of the mode switch algorithm<\/h6><p>Arrhythmia identification is based on :<\/p><ul><li>an atrial rate above which the pacemaker automatically switches to DDI mode (fallback occurs only if the atrial rate is above 120 min-1 ; this parameter cannot be modified)<\/li><li>detection of abrupt atrial rhythm acceleration based on a dynamic window of prematurity = Atrial Rhythm Acceleration Detection (ARAD) window<\/li><li>confirmation based on statistical processing of the atrial arrhythmia in the event of atrial under-detection<\/li><\/ul><p>\u00a0<\/p><h6>The DARA<\/h6><p>DARA is triggered on every stimulated or detected normal atrial event. Its duration, calculated dynamically, depends on the sinus rhythm.<\/p><ul><li>when sinus rhythm is less than 80 min-1, DARA represents 62.5% of the previous P-P interval<\/li><li>when sinus rhythm is greater than (or equal to) 80 min-1, DARA represents 75% of the previous P-P interval<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b869bb6 elementor-widget elementor-widget-image\" data-id=\"b869bb6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a17.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a17\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxMywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExNy5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"501\" height=\"301\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a17.png\" class=\"attachment-large size-large wp-image-6713\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a17.png 501w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a17-300x180.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a17-18x12.png 18w\" sizes=\"(max-width: 501px) 100vw, 501px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bd7e77d elementor-widget elementor-widget-text-editor\" data-id=\"bd7e77d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Phase of suspected atrial arrhythmia (N:1)<\/h6><p>At the onset of rapid atrial rhythm, a short AV delay can be triggered on certain P-wave detections in DARA if, and only if, the R-V or V-V interval that would be applied is greater than 500 ms. This avoids too-rapid ventricular pacing at the start of the episode, before switching to asynchronous mode. During this phase of suspected atrial rhythm disorder, all atrial events detected are marked with refractory period markers (small \u201cp\u201d). The DARA value is then fixed at that of the DARA that detected the very first ESA, and may not exceed 500 ms. The short AV delay that can be triggered after certain P-wave detections in DARA is 30 ms (non-programmable).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b563599 elementor-widget elementor-widget-image\" data-id=\"b563599\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a18.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a18\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxMiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExOC5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"723\" height=\"633\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a18.png\" class=\"attachment-large size-large wp-image-6712\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a18.png 723w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a18-300x263.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a18-14x12.png 14w\" sizes=\"(max-width: 723px) 100vw, 723px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-da3d4b1 elementor-widget elementor-widget-text-editor\" data-id=\"da3d4b1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Ventricular cycles with at least one atrial detection in the DARA window are considered \u201csuspicious\u201d.<\/p><h6>How the mode switch algorithm works<\/h6><p>The mode switch function comprises three distinct phases: a suspicion\/confirmation phase, a dissociation phase and a reassociation phase.<\/p><p><span style=\"text-decoration: underline;\">Suspicion\/confirmation phase<\/span><\/p><p>As soon as a ventricular cycle with suspected atrial arrhythmia is detected, the mode switch algorithm begins an analysis of 32 ventricular cycles (repeated per block of 32 ventricular cycles if necessary).<\/p><p>Atrial arrhythmia is confirmed if one of the following two criteria is met:<\/p><ul><li>28 or more ventricular cycles are suspected during the last 32 ventricular cycles (primary criterion)<\/li><li>18 or more ventricular cycles are suspected during the last two blocks of 32 ventricular cycles (secondary criterion)<\/li><\/ul><p><br \/>The primary criterion is usually reached in around 15 seconds. The secondary criterion may allow retreat despite atrial underdetection.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dbe89d5 elementor-widget elementor-widget-image\" data-id=\"dbe89d5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a19.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a19\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxMSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2ExOS5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"502\" height=\"199\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a19.png\" class=\"attachment-large size-large wp-image-6711\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a19.png 502w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a19-300x119.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a19-18x7.png 18w\" sizes=\"(max-width: 502px) 100vw, 502px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0c92898 elementor-widget elementor-widget-text-editor\" data-id=\"0c92898\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Dissociation phase<\/span><\/p><p>Once one of the Withdrawal criteria has been reached, the pacing mode switches from synchronous (DDD or AAI-SafeR) to asynchronous (DDI). The ventricular pacing frequency gradually decreases (the ventricular escape interval increases by 30 ms every 12 cycles) towards the base frequency, the servo frequency, or the resting frequency.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7510adc elementor-widget elementor-widget-image\" data-id=\"7510adc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a20.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a20\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcxMCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EyMC5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"534\" height=\"307\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a20.png\" class=\"attachment-large size-large wp-image-6710\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a20.png 534w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a20-300x172.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a20-18x10.png 18w\" sizes=\"(max-width: 534px) 100vw, 534px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e2d1dc8 elementor-widget elementor-widget-text-editor\" data-id=\"e2d1dc8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Reassociation phase<\/span><\/p><p>As soon as atrial arrhythmia ceases and sinus rhythm resumes, the ventricular pacing rate is gradually adapted to achieve sinus rhythm. A-V reassociation only occurs if atrial and ventricular rates are slower than 110 min-1. A 500 ms RetroPwatch is applied to the first reassociated ventricle to avoid the onset of an ERT.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ea20667 elementor-widget elementor-widget-image\" data-id=\"ea20667\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a21.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a21\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcwOSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EyMS5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"579\" height=\"306\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a21.png\" class=\"attachment-large size-large wp-image-6709\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a21.png 579w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a21-300x159.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a21-18x10.png 18w\" sizes=\"(max-width: 579px) 100vw, 579px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0f911e7 elementor-widget elementor-widget-text-editor\" data-id=\"0f911e7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h6>Mode switch programming<\/h6><p>This function is activated by default.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-991ac5a elementor-widget elementor-widget-image\" data-id=\"991ac5a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a22.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a22\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcwOCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EyMi5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"561\" height=\"461\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a22.png\" class=\"attachment-large size-large wp-image-6708\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a22.png 561w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a22-300x247.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a22-15x12.png 15w\" sizes=\"(max-width: 561px) 100vw, 561px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-81dc7d5 elementor-widget elementor-widget-text-editor\" data-id=\"81dc7d5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\">Memory queries<\/span><\/p><p>From the Summary screen, an observation is noted indicating:<\/p><p>Time spent in retreat (in %)<br \/>Ventricular rate during periods in retreat<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d337341 elementor-widget elementor-widget-image\" data-id=\"d337341\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a23.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a23\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcwNywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EyMy5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"526\" height=\"436\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a23.png\" class=\"attachment-large size-large wp-image-6707\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a23.png 526w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a23-300x249.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a23-14x12.png 14w\" sizes=\"(max-width: 526px) 100vw, 526px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-18065db elementor-widget elementor-widget-text-editor\" data-id=\"18065db\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Another way to access the fallback episodes is to click on Diagnos. AIDA and then on the Arrhythmia tab.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e96729d elementor-widget elementor-widget-image\" data-id=\"e96729d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a24.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a24\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcwNiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EyNC5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"687\" height=\"950\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a24.png\" class=\"attachment-large size-large wp-image-6706\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a24.png 687w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a24-217x300.png 217w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a24-9x12.png 9w\" sizes=\"(max-width: 687px) 100vw, 687px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ac05097 elementor-widget elementor-widget-image\" data-id=\"ac05097\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a25.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a25\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcwNSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EyNS5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"641\" height=\"511\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a25.png\" class=\"attachment-large size-large wp-image-6705\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a25.png 641w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a25-300x239.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a25-15x12.png 15w\" sizes=\"(max-width: 641px) 100vw, 641px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-473a75d elementor-widget elementor-widget-text-editor\" data-id=\"473a75d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>A detailed weekly or daily view shows &#8211; duration of AF (time in fallback) &#8211; number of AF episodes &#8211; ventricular rate &#8211; percentage of ventricular detections.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e44540c elementor-widget elementor-widget-image\" data-id=\"e44540c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a26.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a26\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcwNCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EyNi5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"698\" height=\"545\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a26.png\" class=\"attachment-large size-large wp-image-6704\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a26.png 698w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a26-300x234.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a26-15x12.png 15w\" sizes=\"(max-width: 698px) 100vw, 698px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6cf4992 elementor-widget elementor-widget-image\" data-id=\"6cf4992\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a27.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm_19_situations_arythmies_a27\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NjcwMywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNlwvMDFcL3BtXzE5X3NpdHVhdGlvbnNfYXJ5dGhtaWVzX2EyNy5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"686\" height=\"544\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a27.png\" class=\"attachment-large size-large wp-image-6703\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a27.png 686w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a27-300x238.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/pm_19_situations_arythmies_a27-15x12.png 15w\" sizes=\"(max-width: 686px) 100vw, 686px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Mode switch during atrial arrhythmias Content General information The management of pacemaker patients with atrial arrhythmia episodes is complex, due to the different types of mechanisms known to trigger atrial arrhythmias, and the risk of ventricular pacing running out of control on detection of a rapid atrial rhythm. Detection of atrial arrhythmias is an ongoing [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":21,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-299","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pacemaker Mode Switch in Atrial Arrhythmias | ECG Guide | Cardiocases<\/title>\n<meta name=\"description\" content=\"How pacemakers switch modes during atrial fibrillation &amp; flutter \u2014 DDD to DDI\/VVI mode switch, ECG recognition, programming &amp; real clinical tracings.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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