A Reappraisal of Pacemaker Timing Cycles Pertaining to Automatic Mode Switching

Automatic mode switching algorithms of dual chamber pacemakers require fundamental changes in the operation of pacemaker timing cycles to optimize detection of supraventricular tachyarrhythmias. The timing cycles related to mode switching are basically independent of the algorithm design. Blanking periods (when the sensing amplifier is temporarily disabled) should be optimized to a relatively small fraction of the pacing cycle to enhance atrial sensing and prevent far-field sensing. This review explains the function of the timing cycles pertaining to mode switching and proposes simpler terminology to facilitate the understanding of pacemaker function and electrographic interpretation of complex recordings.