Badanie EKG metodą Holtera u chorego z urządzeniem wszczepialnym — przykłady algorytmów ograniczających stymulację prawej komory

Abstract

High percentage of right ventricular pacing is associated with an increased risk of adverse clinical events such as worsening of heart failure symptoms or atrial fibrillation. Right ventricular pacing should be minimized especially in patients with heart failure and reduced left ventricular ejection fraction after implantation of one-or two-chamber cardioverter-defibrillator. Adequate atrioventricular delay programming or appropriate pacing mode programming that promotes patients own rhythm for example AAI/DDD or DDD/ADI helps in avoiding right ventricular pacing. There are special algorithms, different between pacemaker-producing companies, basing on the above methods that spare right ventricular pacing. Some of those algorithms can mimic pacemaker dysfunction and can be a challenge during Holter electrocardiogram (ECG) interpretations. In this article Holter ECG examples of different algorithms to reduce right ventricle pacing are presented and discussed.