02_ PPM MODES

Wendy Tan
 NBG CODE
I II III IV
Chamber (s) Chamber (s) Response to Programmability
paced sensed sensing Rate Modulation
O= None O= None O= None O= None

A= Atrium A= Atrium T= Triggered R= Rate Modulation

V= Ventricle V= Ventricle I= Inhibited

D= Dual D= Dual D= Dual

(A+V) (A+V) (T+I)

Refer to Exercise 1

2
SO HOW YOU DECIDE WHICH
CONDITIONS TO WHICH MODE?
 MODE SELECTION DECISION TREE

Symptomatic DDDR DDDR

bradycardia

Y N
Are atrial tachyarrhythmias
Is AV conduction intact?
present?

N Y N
Is AV conduction intact? Are they chronic? VVI
VVIR
Y
Y N Is SA node function
Is SA node function presently adequate?
presently adequate?
Y N
N N (CSS,
(SSS)
VVS)
DDD, VDD
DDDR DDDR
AAIR DDD
DDDR
 QUESTIONS:

 What pacing mode would be most appropriate for this

patient based on the ECG above?
 a) AAIR

 b) VVIR

 c) DDDR

 d) DDIR
C
 QUESTIONS:

 ECG strip shows temporary VVI pacing at 40 ppm. Which of the

following pacing modes would provide the most optimal
hemodynamics?

 a) VVIR
 b) DDIR

C
 c) DDD

 d) AAIR
QUESTIONS:
 The most likely mode to be programmed in the patient
shown above is:

 A. VVIR
 B. VDDR

 C. DDIR

 D. DDDR

B
QUESTION:

 Which of the following modes would be most

appropriate for the above patient?

 A)VVIR
 B)VDDR

 C)AAIR

 D)DDIR
B
QUESTION:

 A 80 yrs old lady with chronic AF was in your lab c/o

occasional giddiness. The physician order a 24hr
ambulatory ECG and it shows that she has frequent pauses
> 5 secs. The patient was scheduled for a pacemaker
implantation next week. Which of the following modes
would be most appropriate for the above patient?

 A)VVIR
 B)VDDR

 C)AAIR

 D)DDIR

A
THANK YOU!