VIP to reduce the percentage of unnecessary right ventricular pacing

Tracing
N° 1
Manufacturer Abbott Device PM Field Pacing Modes
Patient
  • 74-year-old man
  • AccentTM DR  pacemaker (Abbott) for sinus dysfunction
  • 100% right ventricular pacing
  • DDD mode
  • Programming of the VIP algorithm
Graph and trace
  • Atrial pacing and ventricular pacing at the programmed lower rate limit
  • Programming of the VIP algorithm
  • Resumption of intrinsic atrioventricular conduction, ventricular sensing and inhibition of ventricular pacing
Comments
  • There is no specific mode per se to reduce the percentage of unnecessary right ventricular pacing in AbbottTM pacemakers
  • The VIP algorithm corresponds to an AV delay hysteresis
  • The AV delay is prolonged over a limited number of intervals to promote the return of intrinsic conduction
  • At the end of the prolonged AV period, if no ventricular event has occurred, ventricular pacing is delivered
  • There can be no dropped P wave during this search, given that ventricular pacing always occurs at the end of the prolonged AV delay in the absence of ventricular sensing
  • The main advantage of this algorithm is therefore to permanently maintain a 1:1 activation ratio between atria and ventricles
  • On this tracing, activation of the VIP allows reducing the percentage of right ventricular pacing from 100 to 0%
  • In the long term, this should prove beneficial in terms of ventricular remodeling and occurrence of atrial arrhythmia
Other articles that may be of interest to you
Right atrial enlargement
EGM recordings