Von Knorre G H, Ismer B, Voss W, Petzsch M, Pulya K
Department of Cardiology, University of Rostock, Germany.
Pacing Clin Electrophysiol. 1998 Jan;21(1 Pt 2):264-7. doi: 10.1111/j.1540-8159.1998.tb01101.x.
DDD pacemakers differ considerably in device specific extents of AV delay (AVD) programmability. To demonstrate the requirements of a mean DDD pacemaker patient population optimal AVDs in 200 DDD pacemaker patients (age 8 to 91 years) were estimated by left atrial electrography. The results should help to define an AVD programmability standard. Left atrial electrograms were recorded via a bipolar filtered esophageal lead. The method aims on adjusting the left atrial electrogram to 70 ms prior to the ventricular spike, both during VDD and DDD operation of the pacemaker. In atrial sensed stimulation the optimal AVD varied from 40 to 205 ms (100.5 +/- 24.5 ms) and in atrial paced stimulation from 85 to 245 ms (169.1 +/- 24.5 ms). The difference of the mean values is statistically significant (p < 0.001). The difference between both values in the individual patient, the individual AVD correction time, varied from 0 to 170 ms (68.7 +/- 26.6 ms). Thus, from our findings requirements on AV delay programmability standard can be derived: AVDs (1) should have a range from 40 to 250 ms, (2) should be independently programmable during atrial sensed and atrial paced operation, and (3) should provide as nominal settings 100 ms for atrial sensed and 170 ms for atrial paced stimulation.
DDD起搏器在房室延迟（AVD）的设备特定可编程程度上有很大差异。为了证明平均DDD起搏器患者群体的需求，通过左心房电图估计了200名DDD起搏器患者（年龄8至91岁）的最佳AVD。结果应有助于定义AVD可编程性标准。通过双极滤波食管导联记录左心房电图。该方法旨在在起搏器的VDD和DDD操作期间，将左心房电图调整到心室刺激前70毫秒。在心房感知刺激中，最佳AVD为40至205毫秒（100.5±24.5毫秒），在心房起搏刺激中为85至245毫秒（169.1±24.5毫秒）。平均值的差异具有统计学意义（p<0.001）。个体患者中这两个值之间的差异，即个体AVD校正时间，为0至170毫秒（68.7±26.6毫秒）。因此，根据我们的研究结果，可以得出对房室延迟可编程性标准的要求：AVD（1）范围应为40至250毫秒，（2）在心房感知和心房起搏操作期间应可独立编程，（3）应为心房感知提供100毫秒的标称设置，为心房起搏刺激提供170毫秒的标称设置。
