Key result
The fallback feature in a DDD pacemaker was inconsistent during atrial flutter, occurring consistently only when 2xTARP (ms) was less than or equal to URL (ms).
Case Report (n=1)
In DDD pacemakers with a fallback feature, fallback may occur consistently only when 2xTARP (ms) <= URL (ms), highlighting a potential issue during rapid atrial rhythms.
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Clinicians should verify fallback consistency in DDD pacemakers during atrial flutter; case report leaves open need for systematic validation.
Dual chamber pacing may be problematic in patients with paroxysmal atrial arrhythmias. The fallback feature has been incorporated into some devices to avoid tracking of rapid atrial rhythms. A case is reported in which the initiation of fallback was inconsistent during paroxysms of atrial flutter. Evaluation of the ventricular output of an isolated device in response to various applied atrial rates revealed that fallback occurred consistently only when 2xTARP (ms) < or = URL (ms).
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Nancy J. Johnson (1995) conducted a case report in Paroxysmal atrial arrhythmias / atrial flutter (n=1). DDD pacemaker with fallback feature was evaluated on Initiation of fallback during rapid atrial rhythms. The fallback feature in a DDD pacemaker was inconsistent during atrial flutter, occurring consistently only when 2xTARP (ms) was less than or equal to URL (ms).
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