209 How automatic algorithms are used in daily medical practice in dual chamber pacemaker recipients? Intermediate results from a prospective registry

Abstract

Automatic algorithms in pacemakers (PM) allow continuous adaptation of settings to patients’ clinical conditions. Some are dedicated to pacing and others to sensing. One of the objectives of BELUGA on-going, international, prospective registry was to evaluate the use of automatic algorithms available in Insignia™ PM in current medical practice. The percentage (%) of activation of atrio-ventricular search hysteresis algorithm (AVSH), dynamic AV delay (DynAVD), automatic atrial/ventricular sensing (AAS/AVS), ventricular automatic capture (VAC) and the % of use of automatic ventricular threshold test during patients assessment (AVT) are reported at enrolment (Enrol), 3-6 months (FU1) and 9-12 months (FU2) in patients with dual chamber PM (pts). Up to now 804 pts were enrolled and followed during 9.5±3.9 months (age 76±9 years, 57% male, PR interval 196±34 ms, 40% sinus node dysfunction, 27% bradycardia/tachycardia syndrome, 10% 1°AV block, 33% paroxysmal 2° or 3° AV block). PM programming was left to the discretion of the investigator. Atrial and ventricular automatic sensing algorithms were used in less than half of the pts without any increase over the time. During follow-up, ventricular automatic capture algorithm and ventricular automatic threshold test were increasingly used (p<0.01). DynAVD and AVSH were continuously activated in most of the pts (see table).ParameterAAS on (%)AVS on (%)VAC on (%)AVT (%)AVSH on (%)DynAVD on (%)Enrol464069648597FU1453974688797FU2464076718797p (Enrol vs FU2)nsns<0.01<0.01nsns Intermediate results of this study show that automatic algorithms were currently used by the investigators when directly dedicated to right ventricular pacing. However, automatic algorithms dedicated to sensing appeared to be less used in daily medical practice.