Key result
Lengthening AV interval to 300 ms restores atrioventricular synchrony in advanced interatrial block.
Why the study?
Optimal AV interval programming in DDD pacemakers for patients with advanced interatrial conduction block is not well established.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Interatrial block may require AV interval extension in DDD pacing; single case leaves optimal programming open.
The case of a 83-year-old patient undergoing DDD pacemaker implantation for sick sinus syndrome with postimplant detection of advanced interatrial conduction block is described. At nominal AV interval programming values (175 ms), absence of P wave following an atrial spike was observed, and the presence of an interatrial conduction disturbance was demonstrated by a Doppler transmitral flow pattern analysis and transesophageal ECG recording. AV interval lengthening up to 300 ms resulted in proper timing of atrial and ventricular contractions. Awaiting for conclusive data about biatrial pacing, interatrial conduction blocks can be managed in some cases by proper programming of conventional DDD systems.
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Parravicini et al. (2000) conducted a case report in Sick sinus syndrome with advanced interatrial conduction block (n=1). AV interval lengthening vs. Nominal AV interval programming (175 ms) was evaluated on Proper timing of atrial and ventricular contractions. AV interval lengthening up to 300 ms resulted in proper timing of atrial and ventricular contractions in a patient with advanced interatrial conduction block.
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