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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Reduction of right ventricular pacing in patients with sinus node dysfunction using an enhanced search AV algorithm.
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Reduction of right ventricular pacing in patients with sinus node dysfunction using an enhanced search AV algorithm.

机译：使用增强的搜索AV算法减少窦房结功能障碍患者的右心室起搏。

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BACKGROUND: Dual chamber pacing typically results in a high percentage of ventricular pacing. A number of studies have been conducted suggesting detrimental effects of ventricular desynchronization produced by long-term RV pacing. Pacemaker algorithms that extend the AV interval to uncover intrinsic AV conduction have been utilized to reduce ventricular pacing. These algorithms are often limited to AV intervals below 250 ms limiting the ventricular pacing reduction. We hypothesized that by allowing AV intervals to extend beyond 300 ms, a marked reduction in RV pacing can be achieved. METHODS: A total of 30 patients (17 men, mean age 71 +/- 9) with standard Brady indications, and implanted with a Medtronic Kappa 700 pacemaker, were randomized to 2-week treatments with default Search AV (KSAV) parameters or Enhanced Search AV (ESAV) parameters. The Enhanced Search AV algorithm included the capability for continuous adjustment of AV delays and the ability to auto disable in patients with persistent AV block. RESULTS: Among patients with intact AV conduction, percent VP was greater in KSAV versus ESAV (70 +/- 40% vs 19 +/- 28%, P < 0.001). In patients with persistent AV block, the algorithm suspended appropriately and there was no significant change in the percent VP between both arms of the study. In 18/22 patients, percent VP was reduced below 40%. CONCLUSIONS: Substantial reduction in ventricular pacing can be achieved by allowing the AV interval parameters to extend beyond 300 ms using the ESAV algorithm. In patients with AV block, ESAV suspended and patients were paced at their nominal settings.
机译：背景：双腔起搏通常导致高百分比的心室起搏。已经进行了许多研究，表明长期RV起搏会导致心室不同步。延长AV间隔以揭示固有的AV传导的Pacemaker算法已用于减少心室起搏。这些算法通常限于250 ms以下的AV间隔，从而限制心室起搏。我们假设通过允许AV间隔延长到300 ms以上，可以显着降低RV起搏。方法：将总共30例标准布雷迪适应症患者（17名男性，平均年龄71 +/- 9），并植入Medtronic Kappa 700起搏器，随机分配为2周治疗，采用默认Search AV（KSAV）参数或增强型搜索AV（ESAV）参数。增强型搜索AV算法包括连续调整AV延迟的能力以及在患有持续性AV阻滞的患者中自动禁用的能力。结果：在AV传导完整的患者中，KSAV相对于ESAV的VP百分比更高（70 +/- 40％vs 19 +/- 28％，P <0.001）。在患有持续性房室传导阻滞的患者中，该算法已适当暂停，并且研究的两组之间的VP百分比均无明显变化。在18/22例患者中，VP百分比降低至40％以下。结论：通过使用ESAV算法将AV间隔参数扩展到300 ms以上，可以显着减少心室起搏。在患有房室传导阻滞的患者中，ESAV暂停并且患者按照其名义设置起搏。

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