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Optimizing AV Interval in Device Therapy

The document discusses managing patients with intact or intermittent AV conduction, including topics on rate adaptive AV delay, considerations of right ventricular pacing, considerations of long AV delays, and reduced VP+. It describes the operation and programming of rate adaptive AV delay and discusses the rationale and clinical results of right ventricular pacing.

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Carlos Porta
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30 views8 pages

Optimizing AV Interval in Device Therapy

The document discusses managing patients with intact or intermittent AV conduction, including topics on rate adaptive AV delay, considerations of right ventricular pacing, considerations of long AV delays, and reduced VP+. It describes the operation and programming of rate adaptive AV delay and discusses the rationale and clinical results of right ventricular pacing.

Uploaded by

Carlos Porta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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. . . . . . . . . . . . . . . . . . .

Managing patients with


intact/intermittent AV Conduction

Optimizing AV interval in patients


receiving device therapy
. . . . . . . . . . . . . . . . . . .
Topics:
• Rate Adaptive AV delay (RAAV)
• Considerations of Right Ventricular Pacing
• Considerations of long AV delays
• Reduced VP +
Rate-Adaptive AV Delay: Operation
. . . . . . . . . . . . . . . . . . .

• PAV changes when


sensor rate changes

• SAV changes when offset


Mean Atrial Rate
changes

• Linear response
between programmed
Start rate and Stop rate
Rate-Adaptive AV Delay: Programmer
. . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . .

RV pacing: good or not so good?

Rationale and Clinical Results


. . . . . . . . . . . . . . . . . . .
Reduced VP+
• Automatically adjust AV delay to allow:
– Spontaneous ventricular depolarization when intrinsic conduction
occurs
– Optimal AV delay when Ventricular pacing is required
. . . . . . . . . . . . . . . . . . .
Reduced VP+
. . . . . . . . . . . . . . . . . . .
Reduced VP+ summary
A-V Sequences Analyzed and Divided into 3 Zones
Scheduled
Atrial Event V Pace Event
AV Interval

15 ms
“early” 55 ms “on-time” “late”

(need to (need to
reduce AV) extend AV)

• If 8/16 end “late”: (typically in V pacing) the AV is extended by 62 ms,


and search continues until 8/16 end with VS occurring “on-time”
• If 8/16 end with “early”: (VS) The AV is reduced by 8 ms, and the
search continues
• If Max Offset is reached and 8/16 sequences end “late”, (VP) search
is postponed for 15 min, 30 min,1,2,4,8,16 hours. Ten successive
failures at 16 hours and RVP+ is disabled.

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