课件：起搏器基本概念及起搏心电图阅图祁述善.ppt

Knowing the lower rate interval and the PAV interval (A-V interval after a paced atrial event), the V-A interval can be found: V-A interval = lower rate interval minus the AV interval. The V-A interval is the longest period that may elapse after a ventricular event before the atrium must be paced in the absence of atrial activity. The V-A interval is also commonly referred to as the atrial escape interval. This upper rate is defined as the upper activity rate, also known as the upper sensor rate or maximum sensor rate. Before mode switching was available, pacemakers utilized a separate activity/sensor rate and upper tracking rate to limit the rate to which the patient could track (e.g., in the presence of SVTs), but allow the patient to pace to higher rates if they were exercising. The sequence of an atrial intrinsic event being sensed, starting an SAV interval, timing out the SAV interval, and pacing in the ventricle can be referred to as tracking. If the atrial rate begins to increase and continues to increase, is it desirable to let the ventricle track to extremely high rates? No. It is desirable to limit the rate at which the ventricle can pace in the presence of high atrial rates. This limit is called the upper tracking rate. The Post-Ventricular Atrial Refractory Period (PVARP) is the period of time after a ventricular pace or sense when the atrial channel is in refractory. In other words, atrial senses outside of blanking that occur during this period are seen (and marked 揂R) on the marker channel), but do not initiate an AV interval. The purpose of PVARP is to avoid allowing retrograde P waves, far-field R waves, or premature atrial contractions to start an AV interval which would cause the pacemaker to pace in the ventricle at a high rate. The refractory period after a ventricular event (paced or sensed) is designed to avoid restarting of the V-A interval due to a T wave. Ventricular sensed events occurring in the noise sampling portion of the ventricu