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35 Cards in this Set
- Front
- Back
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A and V pacing with AV clocks timing out |
There's really no difference between A&V based timing |
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Ventricular Based Timing |
Starts V-A Clock after the ventricular event. The V-A time never changes, even if the R wave comes in before the AV clock times out. |
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Atrial based timing |
Focuses on the A-A clock. Makes sure that the A-A is always the same amount of time. Extends the V-A clock if an R waves comes in before the AV clock times out. Doesn't care if the AV clock times out. |
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V Based Timing @ Fast Rates with Intrinsic V conduction |
Allows pacing above Max Sensor Rate |
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A Based Timing @ Fast Rates with Intrinsic V conduction |
Does not exceed Max Sensor Rates |
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Atrial Based timing @ slow rates |
can go slower than the low rate for a few beats |
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Pure Atrial Based Timing |
The device counts a PVC as an atrial event and starts the A-A clock, making the V-V time below the Lower Rate. |
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Modified Atrial Based Timing (Pseudo-Atrial Based Timing) |
Applies Ventricular Based Timing after a pacer defined PVC. |
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Most common type of timing primarily used today |
Modified Atrial Based Timing |
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AV Desynchrony |
Can cause PMT (LOAC, PVC, Atrial undersensing, atrial oversensing, all upper rate behaviors, device algorithm) |
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PMT Solutions |
Increase PVARP |
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PMT diagnosed by |
AS/VP, Regular, Fast (MTR), Retrograde P-wave sensed in alert period |
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Retrograde Prevention > PVC |
Triggers an A pace when PVC detected to render the atrium refractory to retrograde activation. |
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Even Number of PVC's |
Can still initiate PMT |
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Sensor-Varied PVARP |
PVARP will shorten as rate increases: Set up for PMT |
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Long AV Delay search with block |
can still initiated PMT |
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AF Supression Algorithm |
Can still initiate PMT |
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PMT AKA |
Endless Loop Tachycardia |
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Crosstalk |
Sensing of a pacing stimulus delivered in the opposite chamber, which results in undesirable PPM response. |
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Ventricular Safety Pacing |
if a V sense occurs during the safety pace window, a pacing pulse is dlievered at a shorter interval |
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AV Delay in the Ventricle |
VB > CDW > Inhibit |
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Programming Cures for Crosstalk |
Reduced atrial output, reduced Ventricular sensitivity, increased ventricular blanking period, last resort: mode change |
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Upper Rate Behavior |
AS/VP |
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Not desirable AV Synchrony |
Paroxysmal Atrial Tachyarrhythmias, Coronoary Artery Disease |
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Fixed Ratio Block (2:1 Block) |
60,000/TARP, the interval between consecutive P-waves is shorter than the total atrial refractory period |
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Wenckebach Upper Rate Behavior |
Occurs when the spontaneous atrial rate exceeds the programmed upper rate limit but is below the 2:1 block point. Upper rate pacing with progressive P-V lengthening occurs until a P-wave falls in PVARP. This results in a pause between tracked beats. |
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Mode Switching |
when the atrial activity meet the criteria for the set rate, the device switches to a mode that does not track P waves (DDI, VDI). |
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AMS Base Rate, A-Tachy Response |
Program a separate rate for when you mode switch. Dropping to this rate, instead of the lower rate. |
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Rate Smoothing |
a programmable option in some devices that prevents the paced rate from changing by more than the programmed % from one cardiac cycle to the next paced cycle |
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Fallback |
an upper rate response that lengthens the (VV) interval by a constant value from the upper rate to the fallback rate. |
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PMT/Algorithm |
lengthen the PVARP |
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TARP |
AV Delay + PVARP |
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Most Physiologic Upper Rate Behavior |
Mode Switch (sensor indicated rate) |
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Least Physiologic Upper Rate Behavior |
Fixed rate or 2:1 block |
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PVARP Algorithm |
PVARP extension algorithms will only extend after the first PVC or every other at most |
