Atrial High Episodes

I have a question concerning the relationship if any,
between Pacemakers and Atrial High Rate Episodes?

Background:

For the first 2/1/2 years since my Pacemaker was implanted,
I have had no episodes of Atrial High Incidents.

However, the last two interrogation reports, indicated episodes
of Atrial High Incidents. Most were of very short duration,
under one minuite. Also, they were clustered in one to two
day periods, occurring over several months.

I did an analysis of the data in the Interrogation Reports,
and noticed that the percentage of Pacing for the Ventricle
was declining; while the percentage of Atrial and Ventricular
Sensing was increasing. The relative percentages of decreases in pacing and increasing in sensing were similar.

Also, the percentage of Atrial Pacing has been increasing over the same period of time.

Question:

My Cardiologist has ordered Blood work, and two tests,
a Nuclear Stress Test and a Echocardiogram, based upon the
episodes of High Atrial Incidents. The Echocardiogram is
is scheduled to check Supraventricular Tachardia,(SVT)

In doing an internet search on SVT, which can cause AFIB,
I noticed that dual chamber pacemakers were listed as a potential cause of AFIB.

I was wondering if anyone is aware of studies or information
regarding the relationshiop between Pacemakers and AFIB?

Thanks very much for your help.

Best Regards,

Beach Boy

3 Comments

Agree

by golden_snitch - 2014-03-17 03:03:09

Totally agree with boxxed. And if the percentage for ventricular and atrial sensing is increasing, as you wrote, the percentage for atrial pacing cannot be increasing, too.

Also, boxxed is right about the unlikelyness of the ventricular pacing caused your Afib - if it's even Afib -, if your ventricular pacing is getting less and less. Atrial high rate episodes can be anything, as boxxed said. In most pacers, everything running faster than your upper programmed rate, is detected as an atrial high rate episode. Don't know what your upper limit is, but if it is, let's say, 160bpm, then everything above that is high rate; atrial fibrillation would be faster than 400bpm in the atria. There are lots of SVTs that can run at around 200bpm or more, AVNRTs for instance.

And last but not least, your high rate episodes could very well be artefacts. Maybe the pacer mistakes something for a high rate episode.

Don't know why you are getting these tests, they won't provide any information on those tachy episodes. A holter monitor for several days would be much better.

Inga

Thank you

by Beach Boy - 2014-03-17 07:03:47


It's very comforting to recieve helpful coments from one's knowlegeble peers.

I will pursue the matter with my Cardiologist.

Thanks very much!!!!!

Beach Boy

asfasf

by boxxed - 2014-03-17 12:03:36

If I recall correctly, 1% RV Apical pacing = 1% increased risk of AF in certain patients. Not sure if V-pacing is the culprit in your case, you say your V-Pacing % is going down. And your v-lead may not have even been placed apically, could have been placed on the septum.

The way you describe AHR, sounds like you have Medtronic. Their MVP algorithm to reduce unnecessary V-Pacing is very good.

But AHR's can be many, many things. Atrial Tach, SVT, AFib, Aflutter. I'd ask your doctor what exactly they saw. Hell, there are times where AHR's are episode that aren't actually even "real". Just the device double counting signal noise.

You know you're wired when...

Your device acts like a police scanner.

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