Eccentricities of DDD (AV Universal) Pacemakers
The widespread use of dual chamber cardiac pacemakers, specifically the AV universal (DDD) devices, has resulted in the recognition of operational patterns which could be interpreted as pacemaker malfunction. These “eccentricities” include the Wenckebach-like period of upper rate limit response, endless loop tachycardia, physiologic and non-physiologic A V delays, and various response patterns to ventricular extrasystoles. The ultimate recognition of these phenomena requires detailed knowledge of the pulse generators’ characteristics. The pacemaker industry, in turn, should attempt to standardize basic DDD characteristics in order to facilitate proper utilization of these sophisticated devices.
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