Background: R-wave synchronised atrial pacing is an effective temporary pacing\ntherapy in infants with postoperative junctional ectopic tachycardia. In the technique\ncurrently used, adverse short or long intervals between atrial pacing and ventricular\nsensing (APââ?¬â??VS) may be observed during routine clinical practice.\nObjectives: The aim of the study was to analyse outcomes of R-wave synchronised\natrial pacing and the relationship between maximum tracking rates and APââ?¬â??VS\nintervals.\nMethods: Calculated APââ?¬â??VS intervals were compared with those predicted by experienced\npediatric cardiologist.\nResults: A maximum tracking rate (MTR) set 10 bpm higher than the heart rate (HR)\nmay result in undesirable short APââ?¬â??VS intervals (minimum 83 ms). A MTR set 20 bpm\nabove the HR is the hemodynamically better choice (minimum 96 ms). Effects of either\nsetting on the APââ?¬â??VS interval could not be predicted by experienced observers. In our\nnewly proposed technique the APââ?¬â??VS interval approaches 95 ms for HR > 210 bpm\nand 130 ms for HR < 130 bpm. The progression is linear and decreases strictly\n(âË?â?? 0.4 ms/bpm) between the two extreme levels.\nConclusions: Adjusting the APââ?¬â??VS interval in the currently used technique is complex\nand may imply unfavorable pacemaker settings. A new pacemaker design is advisable\nto allow direct control of the APââ?¬â??VS interval
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