Hayes D L, Higano S T, Eisinger G
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN.
Pacing Clin Electrophysiol. 1989 Apr;12(4 Pt 1):555-62. doi: 10.1111/j.1540-8159.1989.tb02700.x.
Dual-chamber, rate-modulated pacing (DDDR) has only recently been made available. During exercise, the pacemaker is capable of tracking not only the patient's intrinsic P wave but also the AV sequential sensor-indicated rate response, which depends on the programmed variables of the specific sensor in the DDDR pulse generator. Programmed options that affect the operation of a rate-modulated DDDR device are slope, threshold, reaction time, and recovery time. In addition, one is required to program a base or minimum pacing rate and a maximum tracking rate, as in any DDD device, as well as a maximum sensor rate. It is essential to know and understand all these programmed options if one is to correctly interpret electrocardiograms from a DDDR pacemaker. Interpreting the electrocardiograms also requires an understanding of the sensor-indicated rate of the pacemaker at any given level of exercise, which is determined by the options previously listed and the interaction between the sensor-indicated rate and the patient's intrinsic atrial and ventricular activity. This paper presents electrocardiograms typical of a new DDDR pacemaker undergoing clinical investigation.
双腔频率适应性起搏（DDDR）只是最近才开始应用。在运动期间，起搏器不仅能够跟踪患者自身的P波，还能跟踪房室顺序传感器指示的频率反应，这取决于DDDR脉冲发生器中特定传感器的程控变量。影响频率适应性DDDR装置运行的程控选项包括斜率、阈值、反应时间和恢复时间。此外，与任何DDD装置一样，需要程控一个基础或最低起搏频率、一个最大跟踪频率以及一个最大传感器频率。如果要正确解读来自DDDR起搏器的心电图，了解和理解所有这些程控选项至关重要。解读心电图还需要了解起搏器在任何给定运动水平时的传感器指示频率，这由上述选项以及传感器指示频率与患者自身心房和心室活动之间的相互作用决定。本文展示了一种正在进行临床研究的新型DDDR起搏器的典型心电图。
