Can someone explain the settings for AV block please. The EP was going to set mine to atrial only but when I explained my symptoms she set it to atrial and ventricular pacing at 60bpm. Not sure what this means and why? It certainly has got rid of all my previous symptoms so must be working. 


Pacing modes

by AgentX86 - 2022-05-12 17:00:28

Atrial only pacing makes absolutely no sense for a patient with heart block. I'm positive that something got lost in translation here. Dual mode (DDDor perhaps DDI) pacing would be normal and maybe VVI (ventricular only) if you have permanent AF/AFL. AAI or AAO, not a chance.


by Tracey_E - 2022-05-12 17:51:31

With av block, the atria normally works like it's supposed to, the signal just doesn't make to the ventricles. If the atria beats and the ventricles don't keep up, it will pace the ventricles. If you have 3rd degree block, it's likely this will happen every beat so don't be surprised if you are pacing 100%. 

If your atrial rate ever gets under 60, it's going to pace the atria to bring it up. This is pretty rare if you only have av block, but 60 is a common setting. 

Maximum rate is more important that minimum rate with av block. The pacer will pace the ventricles to keep you in sync, but only up to the upper limit. Sometimes they start out with this number on the low side, esp if you are younger and active. If you excercise and suddenly feel fatigued, this could be why. Easy fix. 

You'll see a lot of talk here about rate response but you are unlikely to use it. That's for when the atrial rate doesn't go up properly on exertion, the pacer jumps in and raises it for us. 

If you feel good, then your settings are good! They like to adjust them at 4-6 weeks once we are healed and the heart has had a chance to get used to being paced. 



by TonyD - 2022-05-15 15:55:28

Thanks. Helpful comments. 

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