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Reduction of RV pacing by continuous optimization of the AV interval

Milasinovic, G ; Sperzel, J ; Smith, TW ; Mead, H ; Brandt, Johan LU ; Haisty, WK ; Bailey, JR ; Roelke, M ; Simonson, J and Gerritse, B , et al. (2006) In PACE 29(4). p.406-412
Abstract
Background: In patients requiring permanent pacing, preservation of intrinsic ventricular activation is preferred whenever possible. The Search AV+ (SAV+) algorithm in Medtronic EnPulse(TM) dual-chamber pacemakers can increase atrioventricular (AV) intervals to 320 ms in patients with intact or intermittent AV conduction. This prospective, multicenter study compared the percentage of ventricular pacing with and without AV interval extension. Methods: Among 197 patients enrolled in the study, the percentage of ventricular-paced beats was evaluated via device diagnostics at the 1-month follow-up. Patient cohorts were defined by clinician assessment of conduction via a 1:1 AV conduction test at the 2-week follow-up. The observed percentage of... (More)
Background: In patients requiring permanent pacing, preservation of intrinsic ventricular activation is preferred whenever possible. The Search AV+ (SAV+) algorithm in Medtronic EnPulse(TM) dual-chamber pacemakers can increase atrioventricular (AV) intervals to 320 ms in patients with intact or intermittent AV conduction. This prospective, multicenter study compared the percentage of ventricular pacing with and without AV interval extension. Methods: Among 197 patients enrolled in the study, the percentage of ventricular-paced beats was evaluated via device diagnostics at the 1-month follow-up. Patient cohorts were defined by clinician assessment of conduction via a 1:1 AV conduction test at the 2-week follow-up. The observed percentage of ventricular pacing with SAV + ON and the predicted percentage of ventricular pacing with SAV + OFF were determined from the SAV + histogram data for the period between the 2-week and 1-month follow-up visits. Results: Of 197 patients, 110 (55.8%) had intact 1:1 AV conduction, of which 109 had 1-month data. SAV + remained ON in 991109 patients; 10 patients had intrinsic A-V conduction intervals beyond SAV + nominal and therefore SAV + disabled. The mean percentage of ventricular pacing in the 109 patients was SAV+ ON = 23.1% (median 3.7%) versus SAV + OFF = 97.2% (median 99.7%). In 87 patients without 1:1 AV conduction, SAV + was programmed OFF in 6, automatically disabled in 52, and remained ON in 29. In 8 of these patients, 80-100% reduction in ventricular pacing was observed with SAV + ON. Conclusion: The Search AV+ algorithm in the EnPulse pacemaker effectively promotes intrinsic ventricular activation and substantially reduces unnecessary ventricular pacing. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
unnecessary ventricular pacing, intrinsic ventricular activation, search AV, dual-chamber pacing
in
PACE
volume
29
issue
4
pages
406 - 412
publisher
Wiley-Blackwell
external identifiers
  • pmid:16650270
  • wos:000237453300012
  • scopus:33645710087
ISSN
1540-8159
DOI
10.1111/j.1540-8159.2006.00361.x
language
English
LU publication?
yes
id
d6248187-1c0a-4b6b-a7f4-672239eea185 (old id 409969)
date added to LUP
2016-04-01 16:14:33
date last changed
2020-06-03 02:46:34
@article{d6248187-1c0a-4b6b-a7f4-672239eea185,
  abstract     = {Background: In patients requiring permanent pacing, preservation of intrinsic ventricular activation is preferred whenever possible. The Search AV+ (SAV+) algorithm in Medtronic EnPulse(TM) dual-chamber pacemakers can increase atrioventricular (AV) intervals to 320 ms in patients with intact or intermittent AV conduction. This prospective, multicenter study compared the percentage of ventricular pacing with and without AV interval extension. Methods: Among 197 patients enrolled in the study, the percentage of ventricular-paced beats was evaluated via device diagnostics at the 1-month follow-up. Patient cohorts were defined by clinician assessment of conduction via a 1:1 AV conduction test at the 2-week follow-up. The observed percentage of ventricular pacing with SAV + ON and the predicted percentage of ventricular pacing with SAV + OFF were determined from the SAV + histogram data for the period between the 2-week and 1-month follow-up visits. Results: Of 197 patients, 110 (55.8%) had intact 1:1 AV conduction, of which 109 had 1-month data. SAV + remained ON in 991109 patients; 10 patients had intrinsic A-V conduction intervals beyond SAV + nominal and therefore SAV + disabled. The mean percentage of ventricular pacing in the 109 patients was SAV+ ON = 23.1% (median 3.7%) versus SAV + OFF = 97.2% (median 99.7%). In 87 patients without 1:1 AV conduction, SAV + was programmed OFF in 6, automatically disabled in 52, and remained ON in 29. In 8 of these patients, 80-100% reduction in ventricular pacing was observed with SAV + ON. Conclusion: The Search AV+ algorithm in the EnPulse pacemaker effectively promotes intrinsic ventricular activation and substantially reduces unnecessary ventricular pacing.},
  author       = {Milasinovic, G and Sperzel, J and Smith, TW and Mead, H and Brandt, Johan and Haisty, WK and Bailey, JR and Roelke, M and Simonson, J and Gerritse, B and Englund, J and Compton, SJ},
  issn         = {1540-8159},
  language     = {eng},
  number       = {4},
  pages        = {406--412},
  publisher    = {Wiley-Blackwell},
  series       = {PACE},
  title        = {Reduction of RV pacing by continuous optimization of the AV interval},
  url          = {http://dx.doi.org/10.1111/j.1540-8159.2006.00361.x},
  doi          = {10.1111/j.1540-8159.2006.00361.x},
  volume       = {29},
  year         = {2006},
}