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Effect of the Atrial Blanking Time On the Detection of Atrial Fibrillation in Dual Chamber Pacing
Author(s) -
NOWAK BERND,
KRACKER STEFAN,
RIPPIN GERD,
HORSTICK GEORG,
VINCENT ALPHONS,
GEIL STEPHANIE,
HIMMRICH EWALD,
MEYER JÜRGEN
Publication year - 2001
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2001.00496.x
Subject(s) - blanking , atrial fibrillation , medicine , cardiology , single chamber , p wave , computer science , computer vision
NOWAK, B., et al. : Effect of the Atrial Blanking Time On the Detection of Atrial Fibrillation in Dual Chamber Pacing. Patients with paroxysmal atrial fibrillation (PAF) and dual chamber pacemakers frequently have short postventricular atrial blanking times and sensitive atrial sensing thresholds used to provide reliable detection and mode switching during AF. However, short atrial blanking times increase the risk of atrial sensing of ventricular far‐field signals. We evaluated if the length of the atrial blanking time influences the detection of AF. The study included ten patients with a VDDR ( n = 7 ) or DDDR system ( n = 3 ), who presented with AF at 18 follow‐up visits. Bipolar atrial sensing was programmed to the most sensitive value. Atrial blanking times were programmed from 100 to 200 ms in 25‐ms steps in each patient. Using marker annotation, the following parameters were measured at ten consecutive ventricular beats: VAF = the interval between ventricular stimulus and first sensing of AF; AFS = the number of atrial‐sensed events between two ventricular events; and XAF = the interpolated number of atrial‐sensed events during atrial blanking time. The intervals between ventricular events and between atrial‐sensed event markers showed no significant differences for the five blanking times tested. There was no significant influence of the atrial blanking time onto the measured parameters (least square means ± standard error) with VAF between 281 ± 12 and 300 ± 12 ms ( P = NS ), AFs between 3.4 ± 0.2 and 3.6 ± 0.2 beats ( P = NS ) and XAF between 1.84 ± 0.12 and 2.03 ± 0.12 beats ( P = NS ). At ventricular rates < 100/min, the atrial sensing of AF in dual chamber pacemakers demonstrated no evidence for deterioration by an increase of the atrial blanking time from 100 to 200 ms. Thus, the risk of ventricular far‐field sensing may be reduced without compromising atrial sensing.