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A New Approach to the Prevention of Endless Loop Tachycardia in DDD and VVD Pacing
Author(s) -
ROGI GIORGIO,
OCCHETTA ERALDO,
PERUCCA ANTONELLO,
MAGNANI ANDREA,
FRANCALACCI GABRIELLA,
AUDOGLIO ROBERTO,
ROSSI PAOLO
Publication year - 1991
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.1540-8159.1991.tb02774.x
Subject(s) - medicine , cardiology , tachycardia , lead (geology) , refractory period , p wave , anesthesia , atrial fibrillation , geomorphology , geology
Endless loop tachycardia (ELT) is a possible complication in dual chamber pacing; it is usually prevented by programming the atrial refractory period (PVARP) longer than the retrograde ventriculoatrial (VA) conduction interval; this in some patients limits the upper rate. In 15 patients with a DDD (nine patients) or a single‐pass lead VDD pacemaker (six patients) and retrograde atrial activation, telemetric recording documented a significant difference in amplitude of antegrade, and retrograde atrial potentials (VDD 1.21 ± 0.32 mV vs 0.56 ± 0.23 mV, P = 0.008; DDD 2.7 ± 1 vs 1.8 ± 1 mV, P ‐ 0.038; Student's t‐test for paired data). In 3/15 patients ELT stopped after programming of atrial sensitivity to a value. greater than the retrograde P wave amplitude; in 11/15 patients this occurred at a sensing value lower than or equal to retrograde P wave amplitude with a high pass band filter operating. One patient required PVARP lengthening. Holter monitoring showed no more ELTs. In most patients with a DDD or single‐pass lead VDD pacemaker with widely programmable sensing amplitude and Hi/Low bandpass filters. individual programming of atrial channel sensitivity prevents ELT without affecting the PVARP and, consequently, upper rate limit.