What does this research mean for the field?

A new automatic mode switching (AMS) algorithm in DDDR pacemakers appropriately detects paroxysmal atrial fibrillation, switching to DDIR mode during arrhythmias and reverting to DDDR upon the return of sinus rhythm. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the clinical performance and reliability of a new automatic mode switching algorithm from DDDR to DDIR mode in patients with paroxysmal atrial tachyarrhythmias.

November 1, 1994Pacing and Clinical Electrophysiology

Initial Experience with a New Algorithm for Automatic Mode Switching from DDDR to DDIR Mode

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Why the study?

Does a DDDR pacemaker with an automatic mode switching algorithm appropriately switch to DDIR mode during paroxysmal atrial fibrillation in patients requiring permanent pacing?

Population

23 patients requiring permanent pacemakers, including 17 with AV block and/or sick sinus syndrome and atrial…

Design

Case_series

Follow-up

1-9 months

Authors

IOI. Eli OvsyshcherBen-Gurion University of the Negev AKAmos KatzElectrophysiology CBCHAVA BONDYSoroka Medical Center

Discussion

Member takes

Implication

Supports AMS algorithm function in paroxysmal AF; leaves open reliability for routine DDDR pacing.

Key Points

To evaluate the clinical performance and reliability of a new automatic mode switching algorithm from DDDR to DDIR mode in patients with paroxysmal atrial tachyarrhythmias.
Implanted the THERA DR pacemaker equipped with an automatic mode switching (AMS) algorithm triggered by mean atrial rates exceeding 182 beats/min in N=23 patients (mean age 71 ± 7 years).
Monitored patients over a 1 to 9 month follow-up period using Holter monitoring and treadmill exercise tests.
Recorded 87 successful AMS episodes, with the device switching from DDDR to DDIR during paroxysmal atrial fibrillation and reverting to DDDR upon return of sinus rhythm.
Paroxysmal supraventricular arrhythmias with atrial rates below 182 beats/min correctly did not trigger the mode switch.

Structured PICO

Does a DDDR pacemaker with an automatic mode switching algorithm appropriately switch to DDIR mode during paroxysmal atrial fibrillation in patients requiring permanent pacing?

Population

23 patients (12 males, mean age 71 +/- 7 years) requiring permanent pacemakers, including 17 with AV block and/or sick sinus syndrome (SSS) and atrial arrhythmias, and 6 with SSS and paroxysmal atrial fibrillation (PAF) (2 with hypertrophic obstructive cardiomyopathy).

Intervention

Implantation of a THERA DDDR device (model 7940) with an automatic mode switching (AMS) algorithm that switches from DDDR to DDIR mode when mean atrial rate is > 182 beats/min.

Outcome

Appropriate clinical function and response to paroxysmal atrial fibrillation (activation of automatic mode switching).surrogate

A DDDR pacemaker with an automatic mode switching algorithm appropriately switches to DDIR mode during paroxysmal atrial fibrillation, potentially extending indications for dual chamber pacing.

Limitations

Early, short-term clinical experience
Small sample size

Cite This Study

Ovsyshcher et al. (1994) studied this question.

synapsesocial.com/papers/6a1bc3181567d2fc4d5eec68 https://doi.org/10.1111/j.1540-8159.1994.tb03772.x

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes

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Initial Experience with a New Algorithm for Automatic Mode Switching from DDDR to DDIR Mode

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Initial Experience with a New Algorithm for Automatic Mode Switching from DDDR to DDIR Mode

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider