Switching my PM to an MVP mode

Hello. My EP has determined that I developed pacemaker mediated syndrome and need to consider a biventricular pacer upgrade.

Before having that procedure I had inquired about reprogramming my device to see if more pacing can be helpful,  he thought it may not be a bad idea to switch my PM to an MVP mode.


Has anyone had these procedures and seen benefits or problems with them, thanks in advance for your advice and thoughts.




MVP mode

by AgentX86 - 2021-05-06 22:50:46

I believe this is a mode where the PM is in AAI(R) mode as long as there is no atrial arrhythmia.  If it's detected the PM switches to DDD(R) mode for some number of beats, then tests to see if AAI mode works, then if it fails (atrial arrhythmia still exists) it switches back to DDD mode, then some time later returns to test AAI mode again.  If I'm right about the above, several here are using this mode.  It reduces RV pacing by switching back to AAI mode when everything is working right.

Are you talking about pacemaker mediaded tachycardia or pacemaker syndrome?  PMT is where there is reverse condution in the AV node, which triggers the atrial lead in the pacemaker, then the pacemaker sensing an atrial beat, fires the ventricular lead, then the electrical impulse loops through the AV node backwards again.  It's "pacemaker mediated" because it's caused by the pacemaker thinking there is atrial activity that isn't match with ventricular, so provides it,  Rinse - repeat.

Pacemaker syndrome, a.k.a. pacemaker induced cardiomyopathy, causes an enlarged heart because the RV and LV are not synchronized.

Switching my PM to an MVP mode

by simonsimon - 2021-05-07 01:46:26

I think it is Pacemaker Syndrome but he called it  pacemaker mediated syndrom. I see them on the 10th so I will clarify 


MVP - managed ventricular pacing

by Gemita - 2021-05-07 03:23:05

Hello Simon,


I attach a Medtronic link explaining all about MVP (managed ventricular pacing) in case this helps.  I do not believe there is any harm having this facility turned on to try to prevent unnecessary pacing in the right ventricle which could be contributing to your present difficulties.

In regard to your question about a pacing upgrade to a biventricular pacemaker (CRT - cardiac resynchronization therapy), this can be very beneficial and help restore synchrony (balance) between the left and right ventricle.  It may take a little while to work but many have had success with this therapy and if your doctors have recommended it for your present difficilties, and you have confidence in them, I would be guided by their advice.

Are you on any medication?  You could ask for a review of your medication too, to see whether any changes might help.  Yes do get a firm diagnosis of your pacemaker mediated condition if you can so that you will know what you are dealing with.

Update:  Simon I have just re-read your previous post.  I see a few CRT recipients have commented too.  I note you have right sided heart failure.  As I said previously, I can only see a benefit in having an upgrade to CRT (to restore lower chamber synchrony) but in the meantime no harm in trying out a few settings adjustments and perhaps asking again if your doctors have ruled out all other "non pacemaker related" treatable causes for your current worsening symptoms?

Pacemaker mediated syndrome

by Dixie Chick 65 - 2021-05-07 08:32:40

This post has my curiosity up since I have developed some unusual symptoms with my dual chamber PM. May 28th will be one year for me. I've gotten along so well and have felt good up until about 10 days ago. I have started having shortness of breath, mostly from ordinary exertion. This feeling of SOB is very inconsistent. Comes and goes. Today I should hear from my device clinic on my latest data transmission. The data was sent on 4/30. I haven't had any other symptoms except occasionally weakness in my arms and legs. Mostly it's the SOB. 
I'd love to hear any thoughts any of you have about what this could be...

By the way, the highest heart rate I've seen is 119 bpm. Also one time when I took my BP I had the " irregular " heartbeat symbol come up.

Any thoughts ???


Dixie Chick 65

by Gemita - 2021-05-07 09:50:41

I think your question will make a good new message from you so that we may all try to give our opinion, especially if you get some news from your device clinic today.  

Sounds like you may be experiencing some electrical disturbances again but your clinic hopefully will confirm what has happened and we can then give you our opinion too.  SOB may be coming from the higher heart rate, irregular rhythm, but let us wait to get a diagnosis if this is in fact a rhythm disturbance causing your symptoms.  Between SOB episodes hopefully you are feeling your normal self.  Try not to worry.  They would have contacted you immediately on 30 April if they saw anything serious heart wise I would think.  Otherwise pop along to see your general doctor for some checks.

PM mediated syndrome

by Dixie Chick 65 - 2021-05-07 10:59:04

i had the same thought right after I posted the question, Gemita !! I’ll do a separate post when I hear from my pm clinic.

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I'm 35 and got my pacemaker a little over a year ago. It definitely is not a burden to me. In fact, I have more energy (which my husband enjoys), can do more things with my kids and have weight because of having the energy.