- Titel
- Pseudo repetitive non-reentrant ventriculoatrial synchrony
- Untertitel
- Current challenges
- Zitierfähige Url:
- https://nbn-resolving.org/urn:nbn:de:bsz:15-qucosa2-1002651
- Quellenangabe
- Pacing and clinical electrophysiology : PACE
Erscheinungsjahr: 2023
Jahrgang: 46
Heft: 6
Seiten: 467-474
ISSN: 0147-8389
E-ISSN: 1540-8159 - Erstveröffentlichung
- 2023
- Abstract (EN)
- Background: We recently described a novel pacemaker-mediated arrhythmia in Abbott cardiac implantable electronic devices (CIED), called pseudo-RNRVAS, that mimics repetitive non-reentrant ventriculoatrial synchrony (RNRVAS), but can appear in patients with ventriculoatrial (VA) block. It is caused by sinus-p-waves, trapped in the post-ventricular atrial refractory period (PVARP), which mimic VA conduction. The p-waves are followed by atrial pacing during the myocardial refractory time, which can trigger atrial fibrillation (AF). Pseudo-RNRVAS and RNRVAS are probably more common than appreciated, but the recognition and differentiation of the two can be challenging because most CIEDs do not recognize and store them. Objective: We illustrate practical challenges in the assessment of Pseudo-RNRVAS and provide programming options that proved safe and effective for preventing Pseudo- RNRVAS and reducing the risk for typical RNRVAS. Methods and Results: We illustrate in 10 patients the characteristics of Pseudo- RNRVAS and their treatment. The outcome regarding the recurrence of pseudo- RNRVAS after 6 months of follow-up was collected. Inappropriate atrial pacing during pseudo-RNRVAS resulted in AF in six patients. After shortening the PVARP in nine, inactivation/reduction of rate response in four, and reduction of the basic pacing rate in one patient, pseudo-RNRVAS was avoided in eight patients and reduced in one. In one patient AF became permanent. Conclusions: Pseudo-RNRVAS is a pacemaker-mediated arrhythmia that can appear in patients without VA conduction and may lead to AF. The suggested adjustments of pacing parameters were safe and effective in preventing the arrhythmia.
- Andere Ausgabe
- Erstveröffentlichung
DOI: 10.1111/pace.14662 - Freie Schlagwörter (EN)
- pacemaker-mediated arrhythmia, dual-chamber pacemaker, atrial fibrillation, repetitive non- reentrant ventriculoatrial synchrony, inappropriate modeswitch
- Klassifikation (DDC)
- 610
- Verlag
- Wiley-Blackwell, Hoboken, NY
- Version / Begutachtungsstatus
- publizierte Version / Verlagsversion
- URN Qucosa
- urn:nbn:de:bsz:15-qucosa2-1002651
- Veröffentlichungsdatum Qucosa
- 11.11.2025
- Dokumenttyp
- Artikel
- Sprache des Dokumentes
- Englisch
- Lizenz / Rechtehinweis
CC BY-NC-ND 4.0