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Noninvasive Assessment of Ventriculo‐Atrial Conduction and Early Experience with the Tachycardia Termination Algorithm in Pacemaker‐Mediated Tachycardia
Author(s) -
FONTAINE JOHN M.,
MALONEY JAMES D.,
CASTLE LON W.,
MORANT VICTOR A.
Publication year - 1986
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 - 10.1111/j.1540-8159.1986.tb05395.x
Subject(s) - medicine , tachycardia , cardiology , atrial tachycardia , algorithm , anesthesia , atrial fibrillation , catheter ablation , computer science
Since Ihe advent of physiologic dual chamber pacing systems, pacemaker‐mediated tachycardia (PMT) has occurred and the need for invasive measurement of ventriculo‐atrial conduction (VAC) has arisen. The variability in VAC and the potential for PMT often make it necessary to assess for the presence or absence of VAC at different points in time. We noninvasively evaluated 20 pacemaker patients for the presence or absence of VAC. We compared ventriculo‐atrial conduction time (VACT) obtained with the atrial sense event marker with that obtained from Holter monitoring and invasive methods. The incidence of spontaneous (S) and induced (I) PMT and the efficacy of the tachycardia termination algorithm (TTA) was assessed. Fourteen of 20 had VAC with invasive or noninvasive methods. Twelve of 19 had PMT (63%); three were sustained (> 15 beats). We conclude that VACT assessed with the atrial sense event marker (ASEM) yielded a high correlation when compared to the Holter monitor data obtained utilizing our methodology. PMT is commonly a nonsustained (<15 beats) event, and the TTA is effective in sustained PMT. Myopotential sensing, atrial premature contractions and loss of atrial capture are common mechanisms in the initiation of PMT.