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Electrocardiographic Manifestations of a Dual‐Chamber, Rate‐Modulated (DDDR) Pacemaker

1989; Wiley; Volume: 12; Issue: 4 Linguagem: Inglês

10.1111/j.1540-8159.1989.tb02700.x

1540-8159

David L. Hayes, Stuart T. Higano, GEORGE EISINGER,

Cardiac Arrhythmias and Treatments

Dual‐chamber, rate‐moduiated pacing (DDDR) has only recently been made available. During exercise, the pacemaker is capable of tracking not only the patient's intrinsic P wave but also the AV sequential sensor‐indicated rate response, which depends on the programmed variables of the specific sensor in the DDDR pulse generator. Programmed options thaf affect the operation of a rate‐modulated DDDR device are slope, threshold, reaction time, and recovery time. In addition, one is required to program a base or minimum pacing rate and a maximum tracking rate, as in any DDD device, as well as a maximum sensor rate. It is essential to know and understand all these programmed options if one is to correctly interpret electrocardiograms from a DDDR pacemaker. Interpreting the electrocardiograms also requires an understanding of the sensor‐indicated rate of the pacemaker at any given level of exercise, which is determined by the options previously listed and the interaction between the sensor‐indicated rate and the patient's intrinsic atrial and ventricular activity. This paper presents electrocardiograms typical of a new DDDR pacemaker undergoing clinical investigation.