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Dual-Chamber Timing

Dual-Chamber Timing. Göran Mathson, 2005. A-A. A-A. AV Delay. AV and PV interval... Late atrial activation. 150 ms. 250 ms. The AV Delay can be programmed max. 100 ms longer than the PV Delay. A-A. AV Delay. A-A. AV Delay. A-A terminated by intrinsic P-wave. A-A. AV Delay.

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Dual-Chamber Timing

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  1. Dual-Chamber Timing Göran Mathson, 2005

  2. A-A

  3. A-A AV Delay

  4. AV and PV interval... Late atrial activation 150 ms 250 ms The AV Delay can be programmed max. 100 ms longer than the PV Delay

  5. A-A AV Delay

  6. A-A AV Delay A-A terminated by intrinsic P-wave

  7. A-A AV Delay A-A terminated by a PVC A-A – AV delay timer starts on detection of a PVC

  8. Noise Mode, Atrial Channel PVARP A-A Interval Relative Absolute Programmable PVARP

  9. A-A AV Delay PVARP Ventricular Refractory Period VRP

  10. A-A AV Delay PVARP VRP VentricularBlanking Period

  11. Example of programmability... 12…51ms 125 175 225 275 325 375 425 475 200 250 300 350 400 450 150

  12. A-A AV Delay PVARP VRP MTRI Maximum Tracking Rate Interval

  13. A-A AV Delay PVARP VRP MTRI Maximum Tracking Rate Interval

  14. Pseudo Wenckebach Upper Rate Behaviour MTR Interval MTR Interval MTR Interval MTR Interval

  15. A-A AV Delay PVARP VRP MTRI MSRI

  16. Markers… • A=Atrial pacedevent • P= Atrial sensedevent • V=Ventricular pacedevent • R= Ventricular sensedevent

  17. DDD(R) Pacing States • AV-Pacing • AR-Pacing • PV-Pacing • PR-Pacing

  18. DDD(R) Pacing States AV-Pacing

  19. DDD(R) Pacing States PV-Pacing

  20. DDD(R) Pacing States PR-Pacing

  21. DDD(R) Pacing States AR-Pacing

  22. Pacing States A V A R P V P R

  23. A P V R 170 142 Atrial Refractory period 617 546 759 694 P R Ventricular Refractory period Markers

  24. DDI Timing

  25. AVI AEI VEI PVARP VRP MSRI

  26. AVI AEI VEI PVARP VRP MSRI

  27. P P P P P P V AVI AEI VEI PVARP VRP MSRI

  28. AVI AEI VEI PVARP VRP MSRI

  29. Intervention Duration Sensor Recovery Rate SearchInterval Cycle Count Cycle Count Advanced Hysteresis Response Intervention-rate Basic rate Hysteresisrate

  30. A V A A A V A V P V P V A V A V R R Crosstalk…

  31. Crosstalk • Decrease atrial output? • Decrease ventricular sensitivity? • Prolong ventricular blanking? • Enable Ventricular Safety Standby!

  32. Crosstalk Detection Window Blanking Period Ventricular Safety Standby

  33. Ventricular Safety Standby Crosstalk V. Safety Pacing after 120 ms

  34. Is Ventricular Safety Pacing Present In This Panel?

  35. Vetricular Safety Pacing

  36. Ventricular Safety Standby Sensing in Crosstalk Detection Window V. Safety Pacing after 120 ms

  37. Ventricular Safety Standby Blanking Period UndersensingV. Pacing after programmed AV Interval

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