Timing Cycles in Dual-Chamber Adaptive Rate Pacemakers and the Consequences for Programming
With the development of new and more sophisticated pacing modes, understanding of pacemaker rhythms can be difficult and time consuming. A profound knowledge of the nomenclature and timing of dual chamber adaptive rate (DDDR) pacing is mandatory to program the parameters and special functions, in order to fine tune the pacing therapy for each individual patient. A DDDR pacemaker can control the cardiac cycle by processing the input of three sources, i.e. the atrium, the ventricle and a sensor circuit. Each of these three inputs impacts every subsequent cardiac cycle, as determined by the programmed timing intervals. Timing intervals are distinct periods that occur during the cardiac cycle and between subsequent cardiac cycles. Pacemaker timing intervals can be compared to the alarms of a clock. At the appropriate ‘time’, the pacemaker delivers a pacing pulse to either the atrium or ventricle, much the same way an alarm rings in a clock at a set time. Timing intervals can be triggered by atrial and ventricular events, both paced and sensed. In addition, timing intervals within and between subsequent cardiac cycles can be modified by sensor control.
- Markowitz HT. Ventricular-and atrial-based timing in rate responsive dual chamber pulse generators. Technical concept paper. Minneapolis, Medtronic Inc., 1989.
- Barold SS, Falkoff MD, Ong LS. A-A and V-V lower rate timing of DDD and DDDR pulse generators. In: Barold SS, Mugica J (eds), New Perspective in Cardiac Pacing. 2. Mount Kisco, NY, Futura Publishing Co., Inc., 1991, pp 203–47.
- Hayes DL. Timing cycles of permanent pacemakers. Cardiol Clinics 1992;10:593–608.
- Hayes DL, Levine PA. Pacemaker timing cycles. In: Ellenbogen KA (ed.), Cardiac Pacing. Boston, MA Blackwell Scientific Publications, 1992, pp 263–308.
- Hayes DL, Ketelson A, Levine P. Understanding timing systems of current DDDR pacemakers. Eur JCPE 1993;3:70–86.
- Furman S. Comprehension of pacemaker timing cycles. In: Furman S, Hayes DL, Holmes Jr DR (eds), A Practice of Cardiac Pacing, 3rd ed. Mount Kisco, NY, Futura Publishing Co., Inc., 1993, pp 135–94.
- Merillat JC. Understanding and assessing DDDR pacing systems. In: Rate-Adaptive Pacing: Perspective in Cardiac Rhythm Management. St Paul, MN, Cardiac Pacemaker, Inc., 1993, pp 53–85.
- Chu-Pak Lau. DDDR Pacing: Lower and upper rate behaviors. In: Rate Adaptive Cardiac Pacing: Single and Dual Chamber. Mount Kisco, NY, Futura Publishing Co., Inc., 1993, pp 271–91.
- Barold SS. Ventricular-versus atrial-based lower rate timing in dual chamber pacemakers: does it really matter? PACE 1995;18:83–96. CrossRef
- Barold SS, Wenckebach upper rate response of dual chamber pacemakers: A reappraisal and proposed new terminology. PACE 1995;18:244–52. CrossRef
- Timing Cycles in Dual-Chamber Adaptive Rate Pacemakers and the Consequences for Programming
- Book Title
- The Pacemaker Clinic of the 90’s
- Book Subtitle
- Essentials in Brady-Pacing
- Book Part
- pp 33-53
- Print ISBN
- Online ISBN
- Series Title
- Developments in Cardiovascular Medicine
- Series Volume
- Series ISSN
- Springer Netherlands
- Copyright Holder
- Kluwer Academic Publishers
- Additional Links
- Industry Sectors
- eBook Packages
To view the rest of this content please follow the download PDF link above.