Barold S S, Fredman C S
Department of Medicine, Genesee Hospital, Rochester, NY 14607, USA.
Pacing Clin Electrophysiol. 1995 Mar;18(3 Pt 1):391-400. doi: 10.1111/j.1540-8159.1995.tb02537.x.
The release of dual chamber pulse generators with atrial-based lower rate timing has added a new dimension to the complexity of pacemaker function and electrocardiography. This discussion focuses on the concept that in pulse generators with pure atrial-based lower rate timing, preservation of the atrial lower rate interval takes hierarchical precedence over all other timing intervals including the ventricular-based upper rate interval. Under certain circumstances whenever upper rate limitation requires extension of the programmed AV interval, a DDD pulse generator with pure atrial-based lower rate timing can violate its atrial-driven upper rate interval to provide constancy of the lower rate interval. Such behavior also has important implications for upper rate control in devices that function in the DDI (DDIR) or DDDR mode with pure atrial-based lower rate timing.
具有基于心房的较低起搏频率计时功能的双腔脉冲发生器的出现，为起搏器功能及心电图的复杂性增添了新的维度。本讨论聚焦于这样一个概念：在具有纯基于心房的较低起搏频率计时功能的脉冲发生器中，维持心房较低起搏频率间期在层级上优先于所有其他计时间期，包括基于心室的较高起搏频率间期。在某些情况下，每当较高起搏频率限制要求延长程控的房室间期时，具有纯基于心房的较低起搏频率计时功能的DDD脉冲发生器可能会违反其心房驱动的较高起搏频率间期，以确保较低起搏频率间期的恒定。这种行为对于在具有纯基于心房的较低起搏频率计时功能的DDI（DDIR）或DDDR模式下工作的设备中的较高起搏频率控制也具有重要意义。
