Effective Management of Atrioventricular Interval for Paroxysmal Atrial Fibrillation That Developed After DDDR Pacemaker Implantation in a Sick Sinus Syndrome Patient.
نویسندگان
چکیده
A 68-year-old man with sick sinus syndrome (SSS) was referred to our department for pacemaker implantation. After implantation of a pacemaker with rate-responsive dual chamber (DDDR) mode and minimized ventricular pacing (MVP) functions, paroxysmal atrial fibrillation (PAF) repeatedly developed. Pacemaker memory showed that the intrinsic atrioventricular (AV) (atrial pacing-ventricular sensing [Ap-Vs]) interval was paradoxically prolonged during rate-responsive atrial single-chamber (AAIR) mode rapid pacing because of MVP. Accordingly, to eliminate the paradoxical prolongation of the AV interval during rapid atrial pacing, we changed MVP to medium AV hysteresis and conducted DDDR mode pacing with rate-dependent AV delay. PAF then sharply decreased without antiarrhythmic drugs.
منابع مشابه
A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome.
AIMS In patients with sick sinus syndrome, bradycardia can be treated with a single-lead pacemaker or a dual-chamber pacemaker. Previous trials have revealed that pacing modes preserving atrio-ventricular synchrony are superior to single-lead ventricular pacing, but it remains unclear if there is any difference between single-lead atrial pacing (AAIR) and dual-chamber pacing (DDDR). METHODS A...
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24-hour Holter monitoring of a 59 year-old man with DDDR pacemaker (programmed mode: DDD) implanted for sick sinus syndrome with paroxysmal atrial fibrillation was performed one month after implantation, due to palpitations. Several episodes of rapid pacing of decreasing rate were detected. Intracardiac recording stored in the pacemaker memory had shown episodes of atrial lead oversensing, whic...
متن کاملPacing for the Suppression of Paroxysmal Atrial Fibrillation in an 87-year-old Patient
BACKGROUND Sinus node dysfunction, atrioventricular (AV) block and atrial fibrillation (AF) are associated with advanced age. Required therapy commonly includes pacemaker implantation. METHODS We report the course of therapy for an 87-year-old with symptomatic sinus node dysfunction and paroxysmal atrial fibrillation who was intolerant of drug therapy. RESULTS The patient received a pacemak...
متن کاملIncidence of atrial fibrillation and thromboembolism in a randomised trial of atrial versus dual chamber pacing in 177 patients with sick sinus syndrome.
OBJECTIVE To analyse the occurrence of atrial fibrillation (AF) and thromboembolism in a randomised comparison of rate adaptive single chamber atrial pacing (AAIR) and dual chamber pacing (DDDR) in patients with sick sinus syndrome and normal atrioventricular (AV) conduction, in which left atrial dilatation and decreased left ventricular fractional shortening had been observed in the DDDR group...
متن کاملAtrial size independently correlates with the development of paroxysmal atrial fibrillation in patients with sick sinus syndrome.
BACKGROUND Atrial fibrillation arises in 20-30% of patients with sick sinus syndrome, increasing the risk of systemic embolization and mortality. The aim of this study was to examine the clinical determinants of development of paroxysmal atrial fibrillation in sick sinus syndrome patients before implantation of a pacemaker. METHODS This case-control survey involved 144 patients (mean age ± SD...
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ورودعنوان ژورنال:
- International heart journal
دوره 56 5 شماره
صفحات -
تاریخ انتشار 2015