Maintaining AV synchrony with leadless VDD pacing in outpatients is challenging at higher sinus rates and frequently requires device reprogramming.
Successful VDD pacing in the outpatient setting during higher sinus rates is more difficult to achieve than can be presumed based on initial feasibility studies. The devices often require multiple reprogramming to maximize AV sequential pacing.
Neugebauer et al. (Tue,) studied this question.