Methods for operating a dual-chamber pacemaker to avoid triggering atrial fibrillation and perpetuation of repetitive ventriculo-atrial synchrony

Abstract

Pacemaker-initiated atrial fibrillation during competitive atrial pacing is a common arrhythmia with potentially serious consequences The novel pacing method proposes a novel way to automatically detect and diagnose competitive atrial pacing, and to deliver an intervention via a pacing stimulus in the atrium simultaneously with delivering a pacing stimulus in the ventricle, and doing this after a longer waiting period. By doing this, potentially hazardous scenarios causing atrial fibrillation in competitive atrial pacing are avoided, while the rhythm regularity and the synchrony between the upper and lower chambers of the heart are maintained. At the same time, the vicious cycle of retrograde conduction from the ventricle to the atrium—the culprit of the problem—is terminated and not allowed to reoccur for several subsequent cardiac cycles, thereby preventing the extended propagation of repetitive non-reentrant ventriculo-atrial synchrony.