Sustained ventricular far-field oversensing occurred in 9% of DDD paced patients, and prolongation of the atrial refractory period was more effective than resetting atrial sensitivity in eliminating it.
Observational (n=137)
Does reprogramming the atrial refractory period or atrial sensitivity prevent far-field oversensing in patients with DDD pacemakers?
In patients with DDD pacemakers, far-field oversensing occurs in approximately 9% of cases and is more effectively eliminated by prolonging the atrial refractory period than by adjusting atrial sensitivity.
UNLABELLED: Far-field oversensing (FFOS) promoted by high atrial sensitivity and short atrial refractory periods induces false positive mode switches. We evaluated the incidence of ventricular FFOS in a population of DDD paced patients. METHODS: One hundred thirty-seven patients (71 +/- 10 years, 76 men) implanted with a Talent DR pacemaker were studied. Before discharge, an analysis of internal data stored in the memories of the PM was performed by the specific software incorporated in the programmer in parallel with a 24-hour Holter recording. Data were validated by a panel of experts. One and 4 months follow-up was based only on the data stored in the PM memories. RESULTS: Pacing indications were atrioventricular block (n = 75), sinus node dysfunction (n = 57), and other (n = 5). Sustained far-field oversensing was observed in 12/137 patients (9%). Out of a total of 3,511 triggered mode switch episodes, FFOS accounted for 20% and 7% of a 311 days cumulative time in mode switch. Inappropriate mode switch episodes induced by far-field were more numerous but shorter than episodes prompted by atrial arrhythmias. Atrial sensitivity was increased in eight patients, successfully in four. Reprogramming of the atrial refractory period (156 +/- 11 ms) was successful in five of six patients. CONCLUSIONS: A 9% rate of ventricular FFOS was observed in an unselected population, easily and automatically diagnosed using the internal memory function and the automatic analysis provided by the programmer. Prolongation of the atrial refractory period was more effective than resetting of the atrial sensitivity in eliminating FFOS.
Bordacher et al. (Wed,) conducted a observational in DDD paced patients (n=137). Talent DR pacemaker was evaluated on Sustained ventricular far-field oversensing (FFOS). Sustained ventricular far-field oversensing occurred in 9% of DDD paced patients, and prolongation of the atrial refractory period was more effective than resetting atrial sensitivity in eliminating it.
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