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Atrial and Ventricular Timing Cycles
Terms in this set (16)
Ventricular refractory period - timing cycle during which the ventricular channel will not respond to incoming signals, ventricular events such as the T wave will not reset the timing cycle.
Ventricular Alert Period
Begins when the refractory period ends, device is on the lookout for sensed events, period ends when an intrinsic event is sensed or ventricular pacing occurs
Ventricular Blanking Period
Absolute refractory period on the ventricular channel timed to coincide with an atrial output to prevent crosstalk inhibition.
Crosstalk detection window timing cycle occurs after the absolute post atrial ventricular blanking period, if a signal is detected in this window, ventricular safety pacing will deliver a ventricular output 100-200ms following the preceding atrial output.
Max Tracking Rate
Initiated by any ventricular event, acts at the absolute speed limit to prevent tracking non-physiologic atrial rates.
Lower rate limit - in a dual chamber pacemaker this base rate is measured from Paced A to Paced A
Max Sensor Rate
In dual chamber pacemaker it is the atrial speed limit for how fast the atrium will sense, based on the sensor indicated rate. In a single chamber RATE RESPONSIVE pacemaker, this can drive pacing in the V or A.
What controls when we pace in the V?
AV Delay (PAV or SAV)
Atrial refractory period, atrial timing cycle that controls when we pace in the ventricle. Only when this timer expires will we pace in the V. AV delay is programmable.
Dynamic AV Delay
Programmed AVD shortens with increasing atrial event (P or S), best for patients with CHB.
Post ventricular atrial refractory period. Initiated by a ventricular event (P or S), designed to prevent or stop PMT by not sensing or tracking retrograde P waves. Programmable value. Normally 250 ms
Post ventricular atrial blanking period - device does not sense or respond to signals during the blanking period. No signals from the V will be seen by the pacemaker's atrial channel, designed to eliminate V to A crosstalk. Programmable.
Total atrial refractory period - new atrial events cannot be tracked. Shortest AVD plus PVARP, will tell you when we have 2:1 pacemaker block. You can indirectly control TARP by programming the AV Delay
Atrial alert period
Begins when TARP ends, atrium is looking to sense and track intrinsic activity.
Atrial blanking period
Absolute refractory period after a paced atrial event, no signals will be sensed or tracked during this time.
Timing cycle from sensed or paced ventricular event to the next paced A event. Not programmable.
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