Key result
Atrial lead far-field R-wave oversensing drives pacing dysfunction across multiple modes but allows specific corrective programming.
Why the study?
Unintended sensing of QRS complexes via atrial pacemaker leads may cause disorders of pacemaker function in AAI, VDD, and DDD pacing, requiring understanding of mechanisms and countermeasures.
Understanding the mechanisms of far-field QRS sensing in atrial pacemaker leads is essential for accurate differential diagnosis and implementation of appropriate countermeasures.
Answers are grounded in this paper and cite their sources.
May aid differential diagnosis of pacemaker malfunction; leaves open prospective validation of countermeasures.
Unintended sensing of QRS complexes via atrial pacemaker leads may cause disorders of pacemaker function in AAI, VDD and DDD pacing. The consequences of this phenomenon depend upon the pacing mode and the timing of the inappropriate sensing as related to the technical characteristics of the pulse generator. With AAI pacemakers, "inappropriate pacemaker bradycardia" may be seen or P-wave undersensing may be simulated. With VDD and DDD systems a special kind of pacemaker mediated tachycardia or apparent P-wave undersensing may result. With knowledge of the underlying mechanisms, differential diagnosis is possible. The countermeasures available are discussed.
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Brandt et al. (1988) conducted a review in Unintended sensing of QRS complexes via atrial pacemaker leads. Unintended sensing of QRS complexes via atrial pacemaker leads can cause pacemaker dysfunction in AAI, VDD, and DDD modes, which can be diagnosed and managed with specific countermeasures.
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