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* * * * * * * * * * * Medtronic, Inc. has developed the MVP (Managed Ventricular Pacing) mode which promotes intrinsic conduction by reducing unnecessary right ventricular pacing. Results on this pacing mode have been reported by Sweeney M, et al. [PACE 2003. Vol. 26;4(Part II):973 Abstract ID #179]. The MVP pacing mode is a dynamic dual chamber pacing mode that is designed to forgo the historical relationship forced to exist between the atrium and the ventricles in all dual-chamber pacing systems: Maintaining a 1:1 relationship between atrial and ventricular events. By monitoring for naturally occurring events such as long PR intervals (first degree heart block) and Wenckebach phenomenon (Mobitz I heart block), this mode manages ventricular pacing through atrial-based timing and no restrictions on the AV interval. The MVP (AAIR?DDDR) mode differs from conventional AAIR mode in that it allows for an occasional dropped beat and provides back-up V-pacing as needed when the patient experiences at least 2 out of 4 beats with loss of AV conduction. Two dropped beats in close proximity (2 out of 4) will cause the device to switch to DDDR operating mode. Complete details on the MVP pacing mode operation will be available from your Medtronic Representative. MVP is not a search feature. It’s a new pacing mode. Saint Jude and Guidant offer only search algorithms. MVP is not a search algorithm * The following three slides graphically depict the three main faces of operation of the MVP pacing mode. Primarily, MVP looks like AAI(R) mode, EXCEPT that it allows for prolonged A-V. It is an atrial-based pacing mode that looks for any consecutive A-A intervals without associated ventricular events. AAI(R) Figure: If your patient has AV conduction, the device will operate in AAI(R) mode. The device will allow prolonged AV intervals and occasional, single, non-conducted normal atrial contractions. Programming Recommendation – For patients with long PR intervals, the device will rem