![]() Continuous atrial pacing at a prescribed rate.Intrinsic R-waves are sensed and inhibit ventricular output.Demand ventricular pacing (ventricles are paced when needed).No alert period or sensing capability (intrinsic R-waves are ignored).Continuous ventricular pacing at a prescribed rate.In practice it is common for only the first 3 letters to be used (VVI, DDD). O: It is not a multi-site pacemaker (it is not used for re-synchronization therapy).R: The pacemaker is capable of rate modulation (increasing rate during periods of increased metabolic demand).D: The pacemaker is capable of triggered pacing (rarely used) and inhibiting itself in response to sensed events.D: The pacemaker is capable of sensing intrinsic cardiac activity in both the atria and ventricles.D: The pacemaker is capable of pacing both the atria and ventricles.Revised NASPE/BPEG Generic (NGB) Pacemaker Code A timer can reset which starts the timing cycle over again from the beginning.A timer can complete its cycle and release a pacing stimulus (or initiate another timing cycle).Pacemakers function based on timing cycles. Prevention and termination of arrhythmias.Does the device need to be interrogated?.Is the rate appropriate for the clinical condition?.Could there be intermittent loss of capture?.Is there a paced rhythm on the monitor?.Could the pacemaker be part of the problem?.What is the reason the patient is undergoing medical evaluation?.The clinician should ask the following questions: However, this information is often not available at the time of medical evaluation (although you can ask to see the patient’s device I.D. The diagnosis that necessitated a pacemaker.Become familiar with the “four faces” of DDD pacingĪ basic knowledge of how pacemakers function can be useful when interpreting paced rhythms.Understand the basics of single chamber and dual chamber pacing modes. ![]() Develop awareness of the revised NASPE/BPEG Generic (NGB) Pacemaker Code.Review the indications for permanent pacing.Jude Medical for consulting Received honoraria from Boston Scientific for speaking and teaching. Rakesh Gopinathannair, MD, MA is a member of the following medical societies: American College of Cardiology, Heart Rhythm Societyĭisclosure: Received consulting fee from St. ![]() Rakesh Gopinathannair, MD, MA Director of Cardiac Electrophysiology, University of Louisville Assistant Professor of Medicine, Division of Cardiovascular Medicine, University of Louisville School of Medicine Noel G Boyle, MB, BCh, MD, PhD is a member of the following medical societies: American College of Cardiology, European Society of Cardiology, Heart Rhythm Society, American College of Physicians Noel G Boyle, MB, BCh, MD, PhD Professor of Medicine, UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center 49(4):522-9.Ĭhirag M Sandesara, MD, FACC, FHRS Clinical Cardiac ElectrophysiologistĬhirag M Sandesara, MD, FACC, FHRS is a member of the following medical societies: American College of Cardiology, Heart Rhythm Society ![]() Accuracy of the pacemaker-mediated tachycardia algorithm in Boston Scientific devices. Validation of device algorithm to differentiate pacemaker-mediated tachycardia from tachycardia due to atrial tracking. Uncommon presentation of drug-refractory pacemaker-mediated common atrioventricular nodal reentrant tachycardia and a simple solution by reprogramming. Horie K, Otomo K, Mori S, Kikuchi Y, Meguro T. Atrial signal variations and pacemaker malsensing during exercise: a study in the time and frequency domain. 7(3):590-4.įrohlig G, Schwerdt H, Schieffer H, Bette L. Selective atrial sensing in dual chamber pacemakers eliminates endless loop tachycardia. Runaway pacemaker: a case report and review. Pacer arrhythmias: myopotential triggering of pacemaker mediated tachycardia. Tracking of atrial flutter during DDD pacing: another form of pacemaker-mediated tachycardia. Endless loop tachycardia started by an atrial premature complex in a patient with a dual chamber pacemaker. Ventriculoatrial conduction and related pacemaker-mediated arrhythmias in patients implanted for atrioventricular block: an old problem revisited. Richter S, Muessigbrodt A, Salmas J, et al. Novel pacemaker-mediated arrhythmia without ventriculoatrial conduction can induce atrial fibrillation. Gjermeni E, Doering M, Richter S, Hindricks G, Bode K. Repetitive nonreentrant ventriculoatrial synchrony: an underrecognized cause of pacemaker-related arrhythmia. Clinical Cardiac Pacing Defibrillation and Resynchronization Therapy. In: Ellenbogen KA, Kay GN, Lau CP, Wilkoff BL, eds. Pacemaker-mediated tachycardia: manufacturer specifics and spectrum of cases.
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