What causes ventricular pacing?

This is known as pacemaker syndrome, and may be due to atrial contraction occurring against closed atrioventricular (AV) valve or atrial contraction occurring too close to ventricular contraction, producing back-pressure in venous circulation systems and loss of atrial contribution to ventricular output.

Why is it important to minimize ventricular pacing?

Reducing unnecessary ventricular pacing has been shown to improve clinical outcomes by reducing the risks of atrial fibrillation (AF)2, 4-6 and heart failure hospitalization (HFH).

What is dual chamber pacing?

Dual-chamber pacemakers have two leads, placed in the right atrium and right ventricle. They act synchronously when a slow natural heart rate is detected to mimic the sequential physiological contraction of the atria and ventricles. Single-chamber pacemakers may be atrial or ventricular.

What is ventricular demand pacing?

Ventricular pacing refers to the electrical stimulation provided to the ventricles of the heart by a pacemaker. It’s intended to regulate the heart rate in individuals with abnormally slow heart rhythm.

How do you reduce ventricular pacing?

In general algorithms designed to minimize ventricular pacing operate by prolonging the AV interval with hysteresis or by switching between DDD and AAI modes; the operative features differ between manufacturers but all of them carry the risk of AV decoupling (defined as > 40% of AV intervals over 300 msec) even when …

What is ventricular safety pacing?

Ventricular safety pacing (VSP) is an algorithm used to prevent crosstalk inhibition and ventricular capture during the vulnerable period. It delivers short-coupled ventricular stimuli after atrial pacing when sensing any activation in the ven- tricular lead after the end of the ventricular blanking period.

Why have a dual-chamber pacemaker?

The doctor programs the dual-chamber pacemaker to regulate the pace of contractions of both chambers. This pacemaker helps the two chambers work together, contracting and relaxing in the proper rhythm. The contractions allow blood to flow properly from the right atrium into the right ventricle.

What to do if pacemaker fails to sense?

Failure to sense intrinsic beats• If the pacemaker is undersensing (it fires at the wrong times or for the wrong reasons), turn up the sensitivity control. Change the battery or pulse generator. Remove items in the room that might be causing electromechanical interference.

When does the nonprogrammable blanking period occur in a dual chamber pacemaker?

In dual-chamber timing, a nonprogrammable ventricular blanking period occurs after a ventricular paced or sensed event to avoid sensing the ventricular pacing pulse or the R wave (intrinsic or captured). This period is 50 to 100 ms in duration and is dynamic, based on signal strength.

Can a dual chamber pacemaker be reprogrammed?

Dual-chamber pacemakers can be reprogrammed in a single-chamber mode as well; for example, if the patient develops permanent atrial fibrillation. On-demand programming has significant advantages, including prolonging battery life and avoiding unnecessary pacing especially in the ventricle.

Which is the highest pacing rate for a pacemaker?

The maximal tracking rate is the highest ventricular pacing rate allowed in response to atrial sensing and is typically set at 110–150 beats/min. This cut-off feature is designed to prevent excessively rapid ventricular pacing during supraventricular arrhythmias.

When is the postventricular atrial blanking period ( pvab ) initiated?

The postventricular atrial blanking period (PVAB) is initiated by a ventricular pace or sensed event (nominally set at 220 ms) to avoid the atrial lead sensing the far-field ventricular output pulse or R wave.