Estella Pulse Generators - BIOTRONIK USA - News

138 Estella Pulse Generators Technical Manual17.1.2 Dual Chamber17.1.2.1 DDDThe DDD mode is clearly indicated if• AV synchrony is needed over a broad range of rates, such as--active or young patients with an adequate increase in atrial rate,and/or--significant hemodynamic indication, and/or--previous occurrence of pacemaker syn drome or of a re ductionin systolic blood pressure of more than 20 mm Hg under ventricularpacing with pulse generator implantation (regardless ofany evidence of retrograde VA conduction).The DDD mode is conditionally indicated in the case of• a complete AV block or of sick sinus syndrome and stable atrial rate,and/or• proof that simultaneously setting the atrial and ventricular ratescan inhibit tachyarrhythmia or if the pulse generator can be set to apacing mode suited for interrupting arrhythmia.The DDD mode is contraindicated in the case of• frequent or persistent supraventricular tachyarrhythmia, includingatrial fibrillation or flutter, and/or• inadequate intra-atrial complexes that do not permit safe sensing,and/or• angina pectoris which would be aggravated by increased heartrates.*17.1.2.2 DDIThe DDI mode is useful in all cases in which dual chamber pacing isnecessary, but where intermittent supraventricular arrhythmiasfrequently occur.* The ACC/AHA Guidelines cannot replace a study of the relevant specializedliterature, especially since the indications and contraindications for usingparticular pacing modes are subject to constant advances in medicalknowledge.