Noise Mode Response at Peak Exercise in a DDD Pacemaker

Three patients are reported whose DDD pacemakers reverted to the asynchronous mode in the absence of skeletal muscle or electromagnetic (EMI) interference. In all three cases, the basic cardiac rhythm was atrial fibrillation with fast ventricular response due to intrinsic AV conduction. Noise reversion was triggered by the patients' own ventricular activity at cycle lengths shorter than the ventricular refractory period of the pulse generator. In one patient, asynchronous AV sequential pacing during atrial fibrillation was noted shortly after resuscitation from ventricular fibrillation; however, the initiation of the malignant ventricular arrhythmia by the pacemaker remains unproven. The mechanism of noise reversion by rapid cardiac activity and possible solutions to the problem by adequate pacemaker design are discussed.

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Failure to Sense P Waves During DDD Pacing

Mechelen

Hart

Boer

1986

Pacing Clinical Electrophis

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ECG tracings of three patients in whom AV universal (DDD) pacemakers were implanted intermittently demonstrated dropped P waves. In one patient, true atrial undersensing was present; in the others, sensing of the atrial electrode was appropriate, but sensing of sinus P waves was intermittently blocked by normal pacemaker operation. In this report we discuss the electrocardiographic diagnosis of atrial undersensing in order to avoid unnecessary reinterventions.

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Noise Mode Response at Peak Exercise in a DDD Pacemaker

Cited by 4 publications

References 8 publications

Noise Reversion in Paced Dogs

Noise Reversion in Paced Dogs

Noise Reversion of a Dual Chamber Pacemaker without Noise

Failure to Sense P Waves During DDD Pacing

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