Tasaki Hirofumi, Ashizawa Naoto, Nagao Shoichi, Fukushima Kiyoyasu, Furukawa Ryuji, Fukae Satoki, Maemura Koji
Department of Cardiovascular Medicine, Nagasaki Genbaku Isahaya Hospital, Japanese Red Cross Society.
Int Heart J. 2015;56(5):558-63. doi: 10.1536/ihj.15-008. Epub 2015 Sep 11.
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.
