{"id":3655,"date":"2025-10-08T19:01:14","date_gmt":"2025-10-08T19:01:14","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=3655"},"modified":"2026-07-11T12:31:36","modified_gmt":"2026-07-11T12:31:36","slug":"atrial-arrhythmia-management-boston-scientific","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/boston-scientific\/atrial-arrhythmia-management-boston-scientific\/","title":{"rendered":"Atrial arrhythmia management Boston Scientific"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3655\" class=\"elementor elementor-3655\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4059f06 e-con-full e-flex e-con e-parent\" data-id=\"4059f06\" 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-2a65da1 elementor-widget elementor-widget-heading\" data-id=\"2a65da1\" 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\">Boston Scientific - Atrial arrhythmia management<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-346b94b elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"346b94b\" 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__346b94b\" 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__346b94b\" 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__346b94b\" 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-2535267 elementor-widget elementor-widget-heading\" data-id=\"2535267\" 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\">Atrial Tachy Response (ATR)<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ca09ae7 elementor-widget elementor-widget-text-editor\" data-id=\"ca09ae7\" 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><strong>Atrial Tachy Response (ATR)<\/strong><\/p><p>The Atrial Tachy Response feature (ATR mode switch) is designed to limit tracking of atrial arrhythmias by automatically mode switching to a non-tracking mode when programmed ATR criteria are met.<\/p><p><em>Step 1: ATR trigger rate is exceeded<\/em><\/p><p>The ATR algorithm continually monitors for sensed atrial events which are equal to or above the programmed Trigger Rate.<\/p><ul><li>all refractory (PVARP) and non-refractory atrial events are included<\/li><li>atrial events within the blanking period or noise windows are not counted<\/li><\/ul><p><em>Step 2: entry count is met<\/em><\/p><p>The Entry Count is a count of atrial events that occur above the Trigger Rate and determines how quickly the atrial arrhythmia is initially detected.<\/p><ul><li>the entry counter increments (+1) for each sensed atrial event equal to or above the trigger Rate<\/li><li>the entry counter decrements (-1) for each sensed or paced atrial event below the trigger rate and each sensed or paced ventricular event in which there has not been an atrial event within the last 2 seconds<\/li><\/ul><p>Once the counter reaches the programmed entry count, duration begins. A lower programmed entry count requires fewer fast atrial events to fulfill this initial detection and begin duration.<\/p><p><em>\u00a0<\/em><em>Step 3: duration criteria is met and the exit count begins<\/em><\/p><p>Duration determines the number of ventricular cycles during which the atrial arrhythmia will be monitored prior to mode switching.<\/p><ul><li>programming a short duration causes the device to mode switch more quickly whereas a long duration prevents mode switching due to shorter, non-sustained atrial arrhythmia episodes<\/li><li>during duration, the exit count increments and decrements to ensure the count remains above zero for the programmed amount of ventricular cycles<\/li><li>in the event of a short, non-sustained episode of atrial tachycardia, the exit count will reach zero prior to the end of duration and no mode switch will occur<\/li><li>if the exit count is above zero at the end of duration, the fallback time and fallback mode will begin<\/li><\/ul><p><em>Step 4: fallback mode is initiated<\/em><\/p><p>The fallback mode is the non-tracking pacing mode, which is initiated once duration is met and remains in effect until the exit count reaches zero.<\/p><ul><li>if both permanent and ATR fallback modes are rate responsive, the device will use the permanent sensor parameters<\/li><li>if the permanent mode is not rate responsive, the ATR fallback mode may be programmed rate responsive using the accelerometer sensor<\/li><\/ul><p><em>Step 5: ventricular paced rate decreases during fallback time<\/em><\/p><p>Fallback time determines how quickly the ventricular-paced rate will decrease to the fallback lower rate limit, sensor-indicated rate or VRR-indicated rate (whichever is faster).<\/p><ul><li>programming a shorter fallback time will result in a faster decrease of the ventricular-paced rate which physicians may consider for patients who are symptomatic at higher ventricular rates<\/li><li>if exit count is met while device is falling back to fallback lower rate limit, it is possible for the rate to drop to normal Brady lower rate limit<\/li><\/ul><p><\/p><p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone wp-image-11364 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/bost-scien-RTA.png\" alt=\"\" width=\"463\" height=\"273\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/bost-scien-RTA.png 463w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/bost-scien-RTA-300x177.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/bost-scien-RTA-18x12.png 18w\" sizes=\"(max-width: 463px) 100vw, 463px\" \/><\/p><p><\/p><p><em>Step 6: ventricular paced rate decreases to the fallback lower rate limit<\/em><\/p><p>The fallback lower rate limit is the separately programmable lower rate, which the ventricular paced rate will decrease to during fallback time.<\/p><ul><li>fallback lower rate limit may be greater than or less than the normal Brady lower rate limit<\/li><\/ul><p><em>Step 7: exit count is met<\/em><\/p><p>The exit count is a count of atrial events that occur below the trigger rate and determines if the device will enter a mode switch following duration or if the device will exit an active mode switch once the atrial arrhythmia ends.<\/p><ul><li>the exit counter increments (+1) for each sensed atrial event equal to or above the trigger rate<\/li><li>the exit counter decrements (-1) for each sensed or paced atrial event below the trigger rate and for each sensed or paced ventricular event in which there has not been an atrial event in the last two seconds<\/li><\/ul><p>The lower the programmed exit count, the faster the device will return to a tracking mode once the atrial arrhythmia ends. All refractory and non-refractory atrial events are included while atrial events within the blanking period or noise windows are not counted.<\/p><ul><li>if the Exit Count reaches zero during Duration, no mode switch will occur<\/li><li>if the count reaches zero during an active ATR episode, the mode switch will end and the device returns to normal programmed settings<\/li><\/ul><p><strong>Atrial Flutter Response (AFR)<\/strong><\/p><p>Atrial Flutter Response provides immediate dissociation of the atrium and ventricle for atrial rates faster than the programmed AFR Trigger Rate. While AFR immediately prevents tracking of atrial arrhythmias and is sometimes referred to as a one beat mode switch, a true mode switch will not occur until ATR criteria are met.<\/p><ul><li>a single atrial sensed event occuring in PVARP triggers an AFR window equal to the programmed Trigger Rate (e.g., Trigger Rate of 230 bpm = AFR window of 260 ms)<\/li><li>if an atrial-sensed event occurs within that AFR window (above the AFR trigger rate), it triggers another AFR window<\/li><li>as atrial-sensed events continue to occur within AFR windows, they are classified as AS in refractory, are not tracked, and retrigger additional AFR windows<\/li><\/ul><p>Dual-chamber operation resumes when both PVARP and the AFR window have expired without an atrial sense occurring within them.<\/p><ul><li>ventricular pacing is not affected by AFR and will always take place as scheduled<\/li><li>atrial pacing is inhibited during AFR windows<\/li><\/ul><p><\/p><p><img decoding=\"async\" class=\"aligncenter wp-image-11369 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-flutter.png\" alt=\"\" width=\"568\" height=\"285\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-flutter.png 568w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-flutter-300x151.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-flutter-18x9.png 18w\" sizes=\"(max-width: 568px) 100vw, 568px\" \/><\/p><p><img decoding=\"async\" class=\"aligncenter wp-image-11373 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-flutter-2.png\" alt=\"\" width=\"553\" height=\"435\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-flutter-2.png 553w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-flutter-2-300x236.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-flutter-2-15x12.png 15w\" sizes=\"(max-width: 553px) 100vw, 553px\" \/><\/p><p><\/p><p><strong>APP\/ProACt<\/strong><\/p><p><\/p><p><em> <\/em><\/p><p>Cet algorithme permet d\u2019augmenter la fr\u00e9quence de stimulation \u00e0 la suite d\u2019une d\u2019ESA afin d\u2019\u00e9viter la succession cycle court &#8211; cycle long.<\/p><p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-11382 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/APSA-ProACT-boston.png\" alt=\"\" width=\"681\" height=\"340\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/APSA-ProACT-boston.png 681w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/APSA-ProACT-boston-300x150.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/APSA-ProACT-boston-18x9.png 18w\" sizes=\"(max-width: 681px) 100vw, 681px\" \/><\/p><ul><li>\u00a0A la suite d\u2019une ESA, l\u2019algorithme ProAct calcule 75 % de l\u2019intervalle VV pr\u00e9c\u00e9dant l\u2019ESA et applique cet intervalle au cycle suivant afin de favoriser la stimulation atriale.<\/li><li>La fr\u00e9quence de stimulation est ensuite progressivement abaiss\u00e9e jusqu\u2019\u00e0 la fr\u00e9quence minimale en prolongeant de 10 ms l\u2019intervalle VV si 4 cycles cons\u00e9cutifs surviennent avec une d\u00e9tection non ESA, aucun \u00e9v\u00e8nement atrial ou une stimulation atriale.<\/li><li>Ce nouvel intervalle VA est utilis\u00e9 jusqu\u2019\u00e0 la d\u00e9tection d\u2019une ESA et le raccourcissement de <br \/>l\u2019intervalle VV par l\u2019algorithme ou jusqu\u2019\u00e0 ce que l\u2019intervalle VV soit \u00e0 nouveau prolong\u00e9 de 10 ms. La fr\u00e9quence PSA\/ProAct indiqu\u00e9e est limit\u00e9e par la valeur de la fr\u00e9quence de stimulation <br \/>maximale PSA\/ProAct.<\/li><\/ul><p><strong>Pr\u00e9f\u00e9rence \u00e0 la stimulation atriale (PSA)<\/strong><br \/>Cet algorithme a pour objectif de pr\u00e9venir la survenue d\u2019une FA en stimulant l\u2019oreillette <br \/>\u00e0 une fr\u00e9quence l\u00e9g\u00e8rement sup\u00e9rieure au rythme intrins\u00e8que (8 ms). La fr\u00e9quence de stimulation atriale est donc augment\u00e9e lorsque des \u00e9v\u00e8nements atriaux d\u00e9tect\u00e9s se <br \/>produisent (raccourcissement de l\u2019intervalle VA de 8 ms). La fr\u00e9quence de stimulation <br \/>PSA est limit\u00e9e par la Fr\u00e9quence de stimulation maximale PSA qui est programmable. En <br \/>l\u2019absence d\u2019\u00e9v\u00e8nement d\u00e9tect\u00e9, la fr\u00e9quence de stimulation est diminu\u00e9e progressivement <br \/>(intervalle V-A augment\u00e9 de 10ms).<\/p><p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-11377 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-PSA.png\" alt=\"\" width=\"787\" height=\"297\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-PSA.png 787w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-PSA-300x113.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-PSA-768x290.png 768w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-PSA-18x7.png 18w\" sizes=\"(max-width: 787px) 100vw, 787px\" \/><\/p><p><\/p><p><strong>Ventricular Rate Regulation (VRR)<\/strong><\/p><p>VRR is designed to reduce the V\u2013V cycle length variability during partially conducted atrial arrhythmias by increasing the ventricular pacing rate. The VRR algorithm calculates a VRR-indicated pacing interval based on a weighted sum of the current V\u2013V cycle length and the previous VRR-indicated pacing intervals.<\/p><p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-11359 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-scienti-pm-fa.png\" alt=\"\" width=\"651\" height=\"355\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-scienti-pm-fa.png 651w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-scienti-pm-fa-300x164.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-scienti-pm-fa-18x10.png 18w\" sizes=\"(max-width: 651px) 100vw, 651px\" \/><\/p><p>La moyenne pond\u00e9r\u00e9e des 32 cycles pr\u00e9c\u00e9dents est utilis\u00e9e pour d\u00e9terminer la fr\u00e9quence <br \/>limite de stimulation en RFV. L\u2019algorithme de RFV r\u00e9pond \u00e0 un historique de plusieurs <br \/>intervalles avec plus d\u2019importance donn\u00e9e aux intervalles r\u00e9cents :<\/p><ul><li>pour les cycles d\u00e9tect\u00e9s : intervalle RFV = 1.1 *1\/16 intervalles Courant + 15\/16 RFV(t-1)<\/li><li>\u00a0pour les cycles stimul\u00e9s : intervalle RFV = 1.1 * 1\/16 intervalles Courant + 15\/16 RFV(t-1)<\/li><\/ul><p>\u00a0<\/p><p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-11390 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-rv-off.png\" alt=\"\" width=\"667\" height=\"301\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-rv-off.png 667w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-rv-off-300x135.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/Boston-rv-off-18x8.png 18w\" sizes=\"(max-width: 667px) 100vw, 667px\" \/><\/p><p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-11391 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-RV-on.png\" alt=\"\" width=\"682\" height=\"291\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-RV-on.png 682w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-RV-on-300x128.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/07\/boston-RV-on-18x8.png 18w\" sizes=\"(max-width: 682px) 100vw, 682px\" \/><\/p><p><\/p>\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>Boston Scientific &#8211; Atrial arrhythmia management Content Atrial Tachy Response (ATR) Atrial Tachy Response (ATR) The Atrial Tachy Response feature (ATR mode switch) is designed to limit tracking of atrial arrhythmias by automatically mode switching to a non-tracking mode when programmed ATR criteria are met. Step 1: ATR trigger rate is exceeded The ATR algorithm [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":51,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3655","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>Boston Scientific Atrial Arrhythmia Mgmt | Cardiocases<\/title>\n<meta name=\"description\" content=\"Boston Scientific mode switch &amp; atrial arrhythmia management \u2014 programming, ECG recognition &amp; tips.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/boston-scientific\/atrial-arrhythmia-management-boston-scientific\/\" 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