title: Effective Management of Atrioventricular Interval for Paroxysmal Atrial Fibrillation That Developed After DDDR Pacemaker Implantation in a Sick Sinus Syndrome Patient.
abstract: A 68-year-old man with sick sinus syndrome (SSS) was referred to our department for pacemaker implantation. After implantation of a pacemaker with rate-responsive dual chamber (DDDR) mode and minimized ventricular pacing (MVP) functions, paroxysmal atrial fibrillation (PAF) repeatedly developed. Pacemaker memory showed that the intrinsic atrioventricular (AV) (atrial pacing-ventricular sensing [Ap-Vs]) interval was paradoxically prolonged during rate-responsive atrial single-chamber (AAIR) mode rapid pacing because of MVP. Accordingly, to eliminate the paradoxical prolongation of the AV interval during rapid atrial pacing, we changed MVP to medium AV hysteresis and conducted DDDR mode pacing with rate-dependent AV delay. PAF then sharply decreased without antiarrhythmic drugs.
authors.affiliation: Department of Cardiovascular Medicine, Nagasaki Genbaku Isahaya Hospital, Japanese Red Cross Society.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tasaki
authors.forename: Naoto
authors.initials: N
authors.lastname: Ashizawa
authors.forename: Shoichi
authors.initials: S
authors.lastname: Nagao
authors.forename: Kiyoyasu
authors.initials: K
authors.lastname: Fukushima
authors.forename: Ryuji
authors.initials: R
authors.lastname: Furukawa
authors.forename: Satoki
authors.initials: S
authors.lastname: Fukae
authors.forename: Koji
authors.initials: K
authors.lastname: Maemura
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001283:Atrioventricular Node / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods; D019468:Disease Management; D004562:Electrocardiography / Q000379:methods; D006801:Humans; D008297:Male; D012804:Sick Sinus Syndrome / Q000628:therapy*