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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Inhibition of ventricular stimulation in patients with dual chamber pacemakers and prolonged AV conduction (see comments)
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Inhibition of ventricular stimulation in patients with dual chamber pacemakers and prolonged AV conduction (see comments)

机译：双腔起搏器和延长的AV传导患者的心室刺激抑制作用（参见评论）

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摘要

Episodes of repetitive P wave undersensing have been described in dual chamber pacemakers due to automatic extension of the postventricular atrial refractory period (PVARP). Pacemaker stimulation was completely inhibited despite the presence of adequate P waves. This study sought to determine whether cycles of repetitive P wave undersensing occur even in the absence of PVARP extension. Two-hundred fifty-five patients were investigated after DDD or VDD pacemaker implantation for intermittent atrioventricular (AV) block. Forty-six episodes of repetitive atrial undersensing were found during 24-hour Holter ECG in nine patients. Pacemaker syndrome-like symptoms occurred. Episodes were elicited by atrial or ventricular premature contractions when (1) native AV conduction was present but considerably prolonged, (2) intrinsic sinus rate exceeded pacemaker intervention rate, and (3) native AV interval plus PVARP exceeded sinus cycle length. Programming of a particularly short AV interval and PVARP helped to reduce the incidence of repetitive P wave undersensing. Patients with dual chamber devices and prolonged native AV conduction are prone to develop episodes of output inhibition. Standard timing cycles may be inappropriate in these patients.
机译：由于心室后不应期（PVARP）的自动延长，在双室起搏器中已描述了重复性P波不足的情节。尽管有足够的P波，但起搏器的刺激被完全抑制。这项研究试图确定即使在没有PVARP扩展的情况下，是否也会发生重复的P波欠感应循环。在DDD或VDD起搏器植入后，对255例患者进行了间歇性房室（AV）阻滞的研究。在24小时Holter心电图检查中发现9例患者发生了46次重复性房室感觉减退。出现起搏器综合症样症状。当（1）存在天然AV传导但明显延长时，（2）固有窦性心率超过起搏器干预率，（3）天然AV间隔加PVARP超过窦性周期长度，则由房性或心室过早收缩引起发作。对特别短的AV间隔和PVARP进行编程有助于减少重复性P波感知不足的发生。具有双腔室设备和长时间的天然AV传导的患者容易出现输出抑制发作。在这些患者中，标准时间周期可能不合适。

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