High Rate Episodes in a Dual Chamber Pacemaker: What is the Mechanism?

2021 ◽  
Author(s):  
VIJAY SHEKAR P ◽  
VICKRAM VIGNESH RANGASWAMY ◽  
MUTHIAH SUBRAMANIAN ◽  
AURAS RAVI ATREYA ◽  
SACHIN YALAGUDRI ◽  
...  
Keyword(s):  
High Rate ◽  
Dual Chamber ◽  
Dual Chamber Pacemaker

scholarly journals Dual Atrial Rhythms: A Case Report Of An Unusual Cause Of Pacemaker Syndrome

2022 ◽  
Author(s):  
Natee Sirinvaravong ◽  
Mark Heimann ◽  
Steve Liskov ◽  
Gan-Xin Yan
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
High Rate ◽  
Mode Switching ◽  
Dual Chamber ◽  
P Waves ◽  
Dual Chamber Pacemaker ◽  
Automatic Mode ◽  
Automatic Mode Switching ◽  
Pacemaker Syndrome

Abstract Background Atrial dissociation (AD) is described as the existence of two simultaneous electrically isolated atrial rhythms. Theoretically, detection of dual atrial rhythms with a sufficiently high rate by pacemaker can lead to automatic mode switching and associated pacemaker syndrome. Such a clinical observation has not been reported before in the literature. Case Summary An 87-year-old female with Ebstein’s anomaly status post tricuspid valve annuloplasty and tricuspid valve replacement and a dual chamber pacemaker presented with congestive heart failure one week after undergoing atrial lead revision. Interrogation of her dual chamber pacemaker revealed two atrial rhythms: sinus or atrial-paced rhythm and electrically isolated atrial tachycardia (AT). Sensing of both atrial rhythms by the pacemaker led to automatic mode switching, which manifested as ventricular paced rhythm with retrograde P waves on electrocardiogram (ECG). Adjusting the atrial lead sensitivity to a level higher than the sensing amplitude of AT restored atrial paced and ventricular sensed rhythm, which resulted in resolution of heart failure symptoms. Discussion Regardless of the cause of AD, there must be electrical insulation between the two rhythms for their independent coexistence in the atria. AD can lead to pacemaker syndrome from automatic mode switching. If the sensing amplitude during sinus rhythm is significantly larger than that of AT, adjusting the atrial lead sensitivity would solve the issue, as in the present case. Otherwise, atrial lead revision, pharmacotherapy or AT ablation should be considered.

scholarly journals Sinus node dysfunction associates with atrial high-rate episodes after DDD pacemaker implantation

2019 ◽  
Author(s):  
Qi Xue ◽  
Hai Zou ◽  
Lihong Wang ◽  
Hong Shao ◽  
Yuan Ma
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Node ◽  
Pacemaker Implantation ◽  
Structural Heart Disease ◽  
Sinus Node Dysfunction ◽  
High Rate ◽  
Atrial Pacing ◽  
Dual Chamber ◽  
Dual Chamber Pacemaker ◽  
Increased Risk

Abstract Background： Patients implanted with pacemakers frequently develop atrial fibrillation. Pacemaker-detected atrial high-rate episodes or AHREs, where one AHRE is defined as ≥ 160beats/min lasting ≥ 5 minutes, may identify patients at increased risk for stroke and death. In this study, we sought to observe whether patients with sinus node dysfunction or atria-ventricular block are more likely to develop AHREs. Methods: A total of 103 patients (age 69.4±13.5 years，58% female) with DDD/DDDR pacemakers were enrolled for the study. These pacemakers were equipped with features that enabled the detection and storage of information such as the dates, durations and sequential episodes of AHRE. Patients were followed up for 2 years and the time of the first occurrence of AHRE was determined at follow-up visit. Other data such as age, gender, structural heart disease, concomitant non-cardiac diseases, the cumulative percentage of atrial pacing (Cum% AP) and ventricular pacing (Cum% VP) were also collected. Results: Atrial fibrillation developed frequently after the dual-chamber pacemaker implantation. AHRE occurred more often in patients with sinus node disease (SND) than those with atrioventricular block (AVB) （OR, 2.553; 95%CI, 1.122-5.814；P=0.045）. Conclusions: AHRE developed frequently after dual-chamber pacemaker implantation. Patients with SND are more likely to develop AF compared to the patients with AVB.

scholarly journals Novel Predictor for New-Onset Atrial High-Rate Episode in Patients With a Dual-Chamber Pacemaker

2021 ◽  
Vol 3 (9) ◽  
pp. 497-503
Author(s):  
Ryo Nishinarita ◽  
Shinichi Niwano ◽  
Jun Oikawa ◽  
Daiki Saito ◽  
Tetsuro Sato ◽  
...  
Keyword(s):  
High Rate ◽  
Dual Chamber ◽  
Dual Chamber Pacemaker ◽  
New Onset

Atrial pacing as a new predictor for atrial high rate episodes in patients with dual-chamber pacemaker

2020 ◽  
Author(s):  
Ana Devesa ◽  
Camila Sofía García-Talavera ◽  
Juan Benezet-Mazuecos ◽  
José Antonio Iglesias ◽  
Esmeralda Serrano ◽  
...  
Keyword(s):  
High Rate ◽  
Atrial Pacing ◽  
Dual Chamber ◽  
Dual Chamber Pacemaker

Predictive value of atrial high-rate episodes for arterial stiffness and endothelial dysfunction in dual-chamber pacemaker patients

2013 ◽  
Vol 44 (1) ◽  
pp. 13-21 ◽  
Author(s):  
Suresh Krishnamoorthy ◽  
Chee W. Khoo ◽  
Hoong S. Lim ◽  
Gregory Y. H. Lip
Keyword(s):  
Endothelial Dysfunction ◽  
Arterial Stiffness ◽  
Predictive Value ◽  
High Rate ◽  
Dual Chamber ◽  
Dual Chamber Pacemaker

Implanting dual-chamber pacemaker through right thoracotomy to establish a canine tachycardia-mediated cardiomyopathy model

2013 ◽  
Vol 33 (9) ◽  
pp. 1008-1011
Author(s):  
Xiao-hua ZHUANG ◽  
Tao XU ◽  
Hao WANG ◽  
De-ning LIAO
Keyword(s):  
Dual Chamber ◽  
Dual Chamber Pacemaker ◽  
Right Thoracotomy

scholarly journals Transcatheter valve-in-valve-in-valve replacement in tricuspid position in a patient with pre-existing permanent dual-chamber pacemaker

2021 ◽  
Author(s):  
Philipp Lake ◽  
Elmar W. Kuhn ◽  
Victor Mauri ◽  
Sascha Macherey ◽  
Julia Kaliba ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Dual Chamber ◽  
Dual Chamber Pacemaker ◽  
Valve In Valve ◽  
Transcatheter Valve

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