Role of the AV Interval in DDD Pacing: Insights into Programming with Respect to Ventricular Functio

Introduction :The original indication for permanent pacing was complete heart block.  The original pacing mode was asynchronous ventricular (VOO) pacing and the results were spectacular but the number of patients who would benefit from these early pacemakers was very limited.  Since this early experience, the indications have grown as have the available pacing modes, the complexity and versatility of these devices and a recognition that when programmed inappropriately, these device may contribute to congestive heart failure and other adverse consequences.   In the late 1970’s to early 1980’s, the medical profession first began to appreciate the adverse consequences associated with the loss of AV synchrony (pacema

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