Premature ventricular contraction response-induced new-onset atrial fibrillation

Daniel J Friedman, Tiffany Chasten, Kenya Anderson, Jessica Mullenix, Kimberly Rider, Albert Y Sun, Daniel J Friedman, Tiffany Chasten, Kenya Anderson, Jessica Mullenix, Kimberly Rider, Albert Y Sun

No abstract available

Keywords: Arrhythmia; Atrial fibrillation; Pacemaker; Postventricular atrial refractory period; Premature ventricular complex.

Figures

Figure 1

Representative device electrogram showing how the atrial pace premature ventricular contraction response (arrow) resulted in a long–short sequence and eventually atrial fibrillation due to an intrinsic atrial event occurring late in the extended postventricular atrial refractory period. RV = right ventricle.

Figure 2

After the atrial pace premature ventricular contraction (PVC) response algorithm was disabled, PVCs occurred without closely coupled atrial pacing. Of note, the intrinsic atrial activity early in the extended postventricular atrial refractory period likely would be too early to result in long–short induced atrial fibrillation even if the PVC response had remained on. LV = left ventricle; RV = right ventricle.

Figure 3

Plot of atrial fibrillation (AF) episode frequency showing an abrupt drop in AF episodes occurring at the time of reprogramming the premature ventricular contraction response algorithm off (star and vertical dashed line). AT = atrial tachycardia.