Ventricular rate greater than Atrial

On my High Rate Episodes report they have the Atrial High Rate Episodes. They give the date, duration, then Max A, Max V, Avg V and Sensor.

The thing that struck me was the Max V was higher than the Max A for a number of the episodes. I had always understood that ventricular rate was less than atrial rate with the AV node filtering out a number of the spurious atrial impulses.

Does this change with a pacemaker?

Judy

4 Comments

Possible explaination

by ElectricFrank - 2011-06-20 01:06:49

The pacemaker can only report what it is able to sense. The atrium is not as powerful a muscle as the ventricle and generates a smaller signal. During a high rate episode all the atrial waves may not be detected.

Just guessing.

frank

weak signals

by judy13 - 2011-06-20 07:06:38

Thanks frank, that is an interesting thought. Makes you wonder about how good it is in figuring out high rate episodes. Of course it can't do much about them, but we wanted to use this as sort of a built in ekg machine!

The EP said it wasn't good at sorting through PACs, he didn't mention PVCs. I had many more PVCs than PACs, I wonder if it is a similar reason or whether I just feature PVCs now -- never did before.

Judy

Same here

by ElectricFrank - 2011-06-21 01:06:13

I show a batch of PVC's and only 1 PAC run on my last report. By the way on the Medtronic pacers the phone reports don't reset the counters, so you have to subtract the previous report unless it was an office check.

frank

Interesting

by judy13 - 2011-06-21 07:06:45

Maybe it is just PACs they do not pick up. I haven't had a phone check yet, but it is good to know they don't reset the counters that way.

Does 1999 PVCs and 78 PVC runs in 68 days seem high? Actually 1,999 sounds almost like a limit has been reached -- you know like the $99.99 bargains at the stores.

Judy

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