Dual-Chamber Timing
Göran Mathson, 2005
A-A
A-A
AV Delay
AV and PV interval... Late atrial activation
150 ms250 ms
The AV Delay can be programmed max. 100 ms longer than the PV Delay
A-A
AV Delay
A-A terminated by intrinsic P-wave
A-A
AV Delay
A-A terminated by a PVC A-A – AV delay timer starts on detection of a PVC
A-A
AV Delay
Noise Mode, Atrial Channel
PVARP
Programmable PVARP
Absolute RelativeA-A Interval
A-A
PVARP
VRP Ventricular Refractory Period
AV Delay
A-A
PVARP
VRP
VentricularBlanking Period
AV Delay
125300
325350
375400150
175200
225250
425450
47527512…51ms
Example of programmability...
A-A
PVARP
VRP
MTRI
Maximum Tracking Rate Interval
AV Delay
Maximum Tracking Rate Interval
A-A
PVARP
VRP
MTRI
AV Delay
MTR Interval MTR Interval MTR Interval MTR Interval
Pseudo Wenckebach Upper Rate Behaviour
A-A
PVARP
VRP
MTRI
MSRI
AV Delay
A = Atrial paced event
P = Atrial sensed event
V = Ventricular paced event
R = Ventricular sensed event
Markers…
AV-Pacing
AR-Pacing
PV-Pacing
PR-Pacing
DDD(R) Pacing States
AV-Pacing
DDD(R) Pacing States
PV-Pacing
DDD(R) Pacing States
PR-Pacing
DDD(R) Pacing States
AR-Pacing
DDD(R) Pacing States
AA V PR RV P
Pacing States
Markers
AV
PR
142546
694
170617
759
P
R
Atrial Refractory period
Ventricular Refractory period
DDI Timing
PVARP
VRP
MSRI
AEI
AVI
VEI
AVI
AEI
PVARP
VRP
VEI
MSRI
AVI
AEI
PVARP
VRP
VEI
MSRI
P P P P P PV
AVI
AEI
PVARP
VRP
VEI
MSRI
Intervention-rate
Hysteresisrate
Basic rate
Advanced Hysteresis Response
Cycle Count
Intervention Duration
Sensor
Recovery
Rate
SearchInterval
Cycle Count
A V A V A V A V A VP VAR
AR
P V
Crosstalk…
Crosstalk
Decrease atrial output?
Decrease ventricular sensitivity?
Prolong ventricular blanking?
Enable Ventricular Safety Standby!
Ventricular Safety Standby
Bla
nki
ng
P
erio
d
Cro
ssta
lk
Det
ecti
on
W
ind
ow
Ventricular Safety Standby
Crosstalk V. Safety Pacing after 120 ms
Is Ventricular Safety Pacing Present In This Panel?
Vetricular Safety Pacing
Ventricular Safety Standby
Sensing in Crosstalk Detection WindowV. Safety Pacing after 120 ms
Ventricular Safety Standby
Blanking Period UndersensingV. Pacing after programmed AV Interval