2003
DOI: 10.1053/eupc.2002.0281
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Mode switching failure during atrial flutter: the '2:1 lock-in' phenomenon

Abstract: '2:1 lock-in' is a typical form of MS failure in patients with atrial flutter and the mechanism is closely linked to the typical atrial sensing windows.

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Cited by 28 publications
(21 citation statements)
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“…The use of atrial leads with a very short tip-to-ring spacing provides several benefits to clinical practice: 1) an effective reduction of inappropriate mode switch due to FFS, 2) a time saving in follow-up visits as no more individual adjustments of the PVAB is needed and 3) a possible lowering of the likelihood of 2∶1 lock-in of atrial flutter [15] by the application of short PVAB intervals (median 60 ms versus 128 ms).…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…The use of atrial leads with a very short tip-to-ring spacing provides several benefits to clinical practice: 1) an effective reduction of inappropriate mode switch due to FFS, 2) a time saving in follow-up visits as no more individual adjustments of the PVAB is needed and 3) a possible lowering of the likelihood of 2∶1 lock-in of atrial flutter [15] by the application of short PVAB intervals (median 60 ms versus 128 ms).…”
Section: Discussionmentioning
confidence: 99%
“…Reducing the atrial sensitivity runs the risk of undersensing during atrial tachyarrhythmias [13], [14] and can therefore end in an underestimation of the atrial tachyarrhythmia burden. Adjusting the PVAB – although highly effective in avoiding inappropriate mode switch [8], [10][12] – encounters some extra time for individual optimization of the parameter in follow-up visits and it is not devoid of tachyarrhythmia misclassification as a 2∶1 lock-in of atrial signals may occur with atrial flutter [15].…”
Section: Introductionmentioning
confidence: 99%
“…This event is defined as the '2:1 lock-in phenomenon' ( figure 6A and B). 34 PVAB to prevent FFRW sensing also prevents the sensing of every second atrial beat, causing the 2:1 lock-in phenomenon during the atrial tachycardia, resulting in a high ventricular paced rate when normal AV conduction is not present. During atrial tachycardia a mode switch will not occur due to this mechanism, if the upper rate limit is programmed at a higher rate than half of the AT/AFL rate.…”
mentioning
confidence: 99%
“…Mode-switching algorithms are designed to alleviate symptoms related to tracking of atrial arrhythmias, that may result in inappropriately rapid or irregular ventricular pacing [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The ideal mode-switching algorithm should discriminate sinus tachycardia, a rhythm that should be tracked, from pathological atrial arrhythmias, rhythms that generally should not be tracked.…”
Section: Introductionmentioning
confidence: 99%