Upper Rate Behavior

Question 1

When in an atrial tracking mode, Auto-PVARP allows 1:1 atrial tracking up to how many bpm?

Answer 1

up to 30bpm above the HR or 100bpm, whichever is greater

Question 2

When in a non-atrial tracking mode, Auto-PVARP allows 1:1 atrial tracking up to how many bpm?

Answer 2

• value varies to:
• promote AV synchrony at a low pacing rate (longer PVARP)
• prevent atrial competitive pacing at a high rate (shorter PVARP) by maintaining a 300ms window from the
  end of PVARP to the next Atrial pace

Question 3

What timing interval limits how short auto-PVARP can shorten the PVARP interval?

Answer 3

• PVAB

- PVARP cannot be shorter than PVAB

Question 4

When will 2:1 block occur?

Answer 4

when the patients sinus rate is faster than the upper tracking rate

Question 5

The Mode Switch Detection rate needs to be at least how many bpm higher than the UTR/USR?

Answer 5

10 bpm or higher

Question 6

In what mode(s) can the USR be faster than, slower than, or the same as the UTR?

Answer 6

DDDR

Question 7

In DDDR mode, does the USR need to be programmed faster than, slower than, or the same as the UTR?

Answer 7

can be faster, slower, or the same as the UTR

Question 8

Which 2 algorithms help reduce RV pacing?

Answer 8

• MVP and Search AV+

Question 9

In dual chamber pacemakers, is Rate Adaptive AV nominally on or off?

Answer 9

nominally off

Question 10

At what UTR is it recommended to turn Rate Adaptive AV (RAAV) on and why?

Answer 10

• 140bpm or higher
• because the 2:1 block rate with nominal settings is 150bpm
• ex: UTR of 140, with auto PVARP on has 2:1 block rate at 150 bpm. Turning RAAV on increase block rate to 167

Question 11

What is the recommended Rate Adaptive AV (RAAV) start rate?

Answer 11

90bpm

Question 12

What should the Rate Adaptive AV (RAAV) stop rate be when the UTR is programmed to 170bpm or higher?

Answer 12

170bpm

Question 13

What should the Rate Adaptive AV (RAAV) stop rate be when the UTR is programmed to less than 170 bpm?

Answer 13

130bpm

Question 14

In what pacing modes is Auto PVARP available and nominally on?

Answer 14

DDD, DDDR, VDD

Question 15

Where can you find recommendation for Rate Adaptive AV (RAAV) rate programming?

Answer 15

under the therapy guide when interrogating the device

Question 16

Question:
What is the 2:1 block rate?
- SAV 150ms
- Min PVARP 290
- RAAV on with max offset -40ms

Answer 16

SAV (150-40) + min PVARP (290) = 400ms = 150bpm

- need to subtract the RAAV max offset from the programmed SAV for this calculation when RAAV is on