VIP to reduce the percentage of unnecessary right ventricular pacing

Tracing

N° 1

Manufacturer Abbott Device PM Field Pacing Modes

Patient

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 Abbott^TM 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