title: A 2:1 AV rhythm: an adverse effect of a long AV delay during DDI pacing and its prevention by the ventricular intrinsic preference algorithm in DDD mode.
abstract: A 91-year-old woman received a dual-chamber pacemaker for sick sinus syndrome and intermittently abnormal atrioventricular (AV) conduction. The pacemaker was set in DDI mode with a 350-ms AV delay to preserve intrinsic ventricular activity. She complained of palpitation during AV sequential pacing. The electrocardiogram showed a 2:1 AV rhythm from 1:1 ventriculoatrial (VA) conduction during ventricular pacing in DDI mode with a long AV interval. After reprogramming of the pacemaker in DDD mode with a 250-ms AV interval and additional 100-ms prolongation of the AV interval by the ventricular intrinsic preference function, VA conduction disappeared and the patient's symptom were alleviated without increasing unnecessary right ventricular pacing.
authors.affiliation: Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Minamiguchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Oginosawa
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Kohno
authors.forename: Masahito
authors.initials: M
authors.lastname: Tamura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Otsuji
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Abe
mesh_terms: D000368:Aged; D000465:Algorithms; D054537:Atrioventricular Block / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods*; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D012804:Sick Sinus Syndrome / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome