EP Protocol


Atrial pacing :


Begin Atrial pacing at 108 (550 msec )


 If 1:1 conduction cannot be achieved, or if the patient exhibits first, second or third degree block, begin AV sequential pacing with an AV delay of 180 ms at a rate of 109 bpm (550 msec R-R interval).  Press the “Start” button and then record 5 minutes of data.


The pie is programmed to begin filling when pacing is detected between 90 and 110 bpm.  If the physician paces out of this HR range, it will be necessary to manually time.

If the R to R’s are very regular, and the HR is 109 or greater, the timer may begin - thinking that the heart is being paced.



The reason that the AV interval should not be too short is that one needs

to get an isoelectric PQ segment for baseline determination.  If the AV

interval is too short the P wave may encroach on the PQ segment.  Too long

an AV interval results in the P wave falling on the portion of the T wave

which is used for determining alternans. This is the reason 180 msec was

chosen.  If needed, the A V interval can be shortened somewhat but to not

less than than 160 msec.