Effect of varying atrial sensitivity, AV interval, and detection algorithm on automatic mode switching

Eugen C. Palma, Vaidya Kedarnath, Viren Vankawalla, Carolyn A. Andrews, Sandra Hanson, Seymour Furman, Jay N. Gross

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Automatic made switching (AMS) is absolutely dependent on atrial tachyarrhythmia detection. The effects of programming several features that could influence tachyarrhythmia detection were assessed in 18 patients (six women; mean age 64 years) with pacemakers having AMs capability. The atrial electrogram amplitude in sinus rhythm at implant (SR-EGM), last measured atrial sensing threshold prior to tachycardia (A-SENS), and atrial sensing threshold for effective AMS during atrial tachyarrhythmia (AMS-SENS) were obtained. Additionally, ten patients had A V intervals increased from 60 to 200 ms, while seven patients had detection algorithms made more stringent from 5 beats at 150 beats/min to 11 beats at 200 beats/min to assess their effects on AMS efficacy. Results: Sensitivities: Mean SR-EGM = 3.55 mV; mean A-SENS = 2.06 mV; and mean AMS-SENS = 1.46 mV. Fourteen patients developed a trial fibrillation and four atrial flutter. Thirteen of 14 patients who developed a trial fibrillation sensed adequately at ≤ 1.0 mV in normal sinus rhythm (NSR), but only six patients had effective AMS at these settings in atrial fibrillation. Three of four patients who developed atrial flutter had effective AMS at ≤ 2.0 mV. AV Interval: AMS was effective in eight often patients at A V intervals up to 200 ms. One patient lost AMS at an AV interval of 120 ms. Algorithm: In two of seven patients, AMS was not effective if the detection algorithm was more stringent than five beats at 150 beats/min. Conclusions: (1) In atrial fibrillation, effective AMS requires more sensitive atrial settings than in NSR; (2) AV intervals as short as 120 ms can interfere with AMS function; and (3) More stringent detection algorithms may be inappropriate for effective AMS function.

Original languageEnglish (US)
Pages (from-to)1734-1739
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume19
Issue number11 II
StatePublished - 1996

Fingerprint

Tachycardia
Atrial Flutter
Atrial Fibrillation
Cardiac Electrophysiologic Techniques

Keywords

  • atrial tachyarrhythmias
  • automatic mode switch
  • sensors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of varying atrial sensitivity, AV interval, and detection algorithm on automatic mode switching. / Palma, Eugen C.; Kedarnath, Vaidya; Vankawalla, Viren; Andrews, Carolyn A.; Hanson, Sandra; Furman, Seymour; Gross, Jay N.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 19, No. 11 II, 1996, p. 1734-1739.

Research output: Contribution to journalArticle

@article{f24be234e8594d1bbaae53a8ecf63ab6,
title = "Effect of varying atrial sensitivity, AV interval, and detection algorithm on automatic mode switching",
abstract = "Automatic made switching (AMS) is absolutely dependent on atrial tachyarrhythmia detection. The effects of programming several features that could influence tachyarrhythmia detection were assessed in 18 patients (six women; mean age 64 years) with pacemakers having AMs capability. The atrial electrogram amplitude in sinus rhythm at implant (SR-EGM), last measured atrial sensing threshold prior to tachycardia (A-SENS), and atrial sensing threshold for effective AMS during atrial tachyarrhythmia (AMS-SENS) were obtained. Additionally, ten patients had A V intervals increased from 60 to 200 ms, while seven patients had detection algorithms made more stringent from 5 beats at 150 beats/min to 11 beats at 200 beats/min to assess their effects on AMS efficacy. Results: Sensitivities: Mean SR-EGM = 3.55 mV; mean A-SENS = 2.06 mV; and mean AMS-SENS = 1.46 mV. Fourteen patients developed a trial fibrillation and four atrial flutter. Thirteen of 14 patients who developed a trial fibrillation sensed adequately at ≤ 1.0 mV in normal sinus rhythm (NSR), but only six patients had effective AMS at these settings in atrial fibrillation. Three of four patients who developed atrial flutter had effective AMS at ≤ 2.0 mV. AV Interval: AMS was effective in eight often patients at A V intervals up to 200 ms. One patient lost AMS at an AV interval of 120 ms. Algorithm: In two of seven patients, AMS was not effective if the detection algorithm was more stringent than five beats at 150 beats/min. Conclusions: (1) In atrial fibrillation, effective AMS requires more sensitive atrial settings than in NSR; (2) AV intervals as short as 120 ms can interfere with AMS function; and (3) More stringent detection algorithms may be inappropriate for effective AMS function.",
keywords = "atrial tachyarrhythmias, automatic mode switch, sensors",
author = "Palma, {Eugen C.} and Vaidya Kedarnath and Viren Vankawalla and Andrews, {Carolyn A.} and Sandra Hanson and Seymour Furman and Gross, {Jay N.}",
year = "1996",
language = "English (US)",
volume = "19",
pages = "1734--1739",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "11 II",

}

TY - JOUR

T1 - Effect of varying atrial sensitivity, AV interval, and detection algorithm on automatic mode switching

AU - Palma, Eugen C.

AU - Kedarnath, Vaidya

AU - Vankawalla, Viren

AU - Andrews, Carolyn A.

AU - Hanson, Sandra

AU - Furman, Seymour

AU - Gross, Jay N.

PY - 1996

Y1 - 1996

N2 - Automatic made switching (AMS) is absolutely dependent on atrial tachyarrhythmia detection. The effects of programming several features that could influence tachyarrhythmia detection were assessed in 18 patients (six women; mean age 64 years) with pacemakers having AMs capability. The atrial electrogram amplitude in sinus rhythm at implant (SR-EGM), last measured atrial sensing threshold prior to tachycardia (A-SENS), and atrial sensing threshold for effective AMS during atrial tachyarrhythmia (AMS-SENS) were obtained. Additionally, ten patients had A V intervals increased from 60 to 200 ms, while seven patients had detection algorithms made more stringent from 5 beats at 150 beats/min to 11 beats at 200 beats/min to assess their effects on AMS efficacy. Results: Sensitivities: Mean SR-EGM = 3.55 mV; mean A-SENS = 2.06 mV; and mean AMS-SENS = 1.46 mV. Fourteen patients developed a trial fibrillation and four atrial flutter. Thirteen of 14 patients who developed a trial fibrillation sensed adequately at ≤ 1.0 mV in normal sinus rhythm (NSR), but only six patients had effective AMS at these settings in atrial fibrillation. Three of four patients who developed atrial flutter had effective AMS at ≤ 2.0 mV. AV Interval: AMS was effective in eight often patients at A V intervals up to 200 ms. One patient lost AMS at an AV interval of 120 ms. Algorithm: In two of seven patients, AMS was not effective if the detection algorithm was more stringent than five beats at 150 beats/min. Conclusions: (1) In atrial fibrillation, effective AMS requires more sensitive atrial settings than in NSR; (2) AV intervals as short as 120 ms can interfere with AMS function; and (3) More stringent detection algorithms may be inappropriate for effective AMS function.

AB - Automatic made switching (AMS) is absolutely dependent on atrial tachyarrhythmia detection. The effects of programming several features that could influence tachyarrhythmia detection were assessed in 18 patients (six women; mean age 64 years) with pacemakers having AMs capability. The atrial electrogram amplitude in sinus rhythm at implant (SR-EGM), last measured atrial sensing threshold prior to tachycardia (A-SENS), and atrial sensing threshold for effective AMS during atrial tachyarrhythmia (AMS-SENS) were obtained. Additionally, ten patients had A V intervals increased from 60 to 200 ms, while seven patients had detection algorithms made more stringent from 5 beats at 150 beats/min to 11 beats at 200 beats/min to assess their effects on AMS efficacy. Results: Sensitivities: Mean SR-EGM = 3.55 mV; mean A-SENS = 2.06 mV; and mean AMS-SENS = 1.46 mV. Fourteen patients developed a trial fibrillation and four atrial flutter. Thirteen of 14 patients who developed a trial fibrillation sensed adequately at ≤ 1.0 mV in normal sinus rhythm (NSR), but only six patients had effective AMS at these settings in atrial fibrillation. Three of four patients who developed atrial flutter had effective AMS at ≤ 2.0 mV. AV Interval: AMS was effective in eight often patients at A V intervals up to 200 ms. One patient lost AMS at an AV interval of 120 ms. Algorithm: In two of seven patients, AMS was not effective if the detection algorithm was more stringent than five beats at 150 beats/min. Conclusions: (1) In atrial fibrillation, effective AMS requires more sensitive atrial settings than in NSR; (2) AV intervals as short as 120 ms can interfere with AMS function; and (3) More stringent detection algorithms may be inappropriate for effective AMS function.

KW - atrial tachyarrhythmias

KW - automatic mode switch

KW - sensors

UR - http://www.scopus.com/inward/record.url?scp=0029958324&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029958324&partnerID=8YFLogxK

M3 - Article

VL - 19

SP - 1734

EP - 1739

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 11 II

ER -