Dual Chamber Pacing

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  1. AV sequential Pacing
    one atrial beat for each ventricular beat
  2. Dual Chamber Rate is comprised of?
    AV Delay & VA interval
  3. In DDD mode what do you pace the atrium at?
    • lower rate limit
    • (60 bpm)
  4. AV Delay + VA interval=
    Base Rate
  5. When do you pace the ventricle?
    When AV conduction slows
  6. Atrial Tracking
    Patients intrinsic atrial activity increase above the base rate and the ventricular rate paces to mach up to the max tracking rate
  7. 4 checks in Dual Chamber Pacemaker
    • AV Delay
    • VA interval
    • Base Rate
    • MTR
  8. AP-VP
    Sequational pacing
  9. Atrial Sensing & Ventricular Pacing
  10. Atrial Sensing Ventricular Sensing
    Total Inhibition Bitch!
  11. AV Delay
    pacemaker timing cycle design to simulate the natural pause between the atrial and ventricular events by mimicking the PR interval
  12. Benefits of properly time Av dely
    • *optimal time for ventricular filling = better cardiac output
    • *allows time for mitral valve to close
    • *enhances bloodflow (hemodynamics)
  13. Paced AV Delay
    time between paced atrial event and paced ventricular event
  14. Sensed AV Delay
    time period between instrinic p wave and pace QRS
  15. Atrial Latency
    time between the firing of SA node and the waves getting to the atrial lead
  16. How long is Atrial Latency and why is it important
    25-50 ms

    have to set sensed AV delay 25-50 ms shorter than paced AV delay
  17. PR interval should be what percentage of cardiac cylce
  18. Typical PVARP time?
    250-275 ms
  19. Benefit of PVARP
    • prevents premature beats
    • retrograde p-waves
    • far-field ventricular signals
    • pacemaker mediated tachycardias
  20. PVAB
    • Post ventricular atrial blanking
    • typical 100ms
  21. 4 requirements of pacemaker medicated tachycardia
    • DDD pacemaker
    • ability to conduct retrograde
    • triggered event )loss of AV scynorne
    • retrograde conduction longer than PVRAP
  22. Pacemaker-Mediated Tachycardia
    an endless loop tachycardia
  23. Typical triggers for PMT
    • PVC
    • loss of atrial capture
    • atrial undersensing
    • magnet removal
  24. Easiest way to prevent a PMT
    extended PVARP bitch
  25. How to measure VA conduction
    • force pacing by inceasing atrial pacing over intrinisc rate
    • put in VVI mode
    • look for an atrial sense event dirved from ventricular pacing
    • measure RVAC interval
  26. Typical PMT interval
  27. +PVARP
    extends PVARP value to 480ms whenever a PVC occurs
    at a certian amount of beats the pacemaker will automatically extend PVARP
  29. Primary purpose of PVAB
    guard against fairfeild r waves
  30. Fair feild R waves
    sensing r wave from ventricle in atrium
Card Set:
Dual Chamber Pacing
2013-10-09 00:06:43
Dual Chamber

Dual Chamber Pacing
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