Post Mode-Switch Overdrive Pacing Feature
Post Mode-Switch Overdrive Pacing (PMOP) works with the Mode Switch feature to deliver overdrive atrial pacing following an AT/AF episode termination.
When the AT/AF episode has terminated, the device will pace at a programmed higher rate for a programmed period of time.
This feature can be found in some Medtronic Pacemaker, ICD, CRT-P, and CRT-D devices. Please go to manuals.medtronic.com or consult with your local Medtronic representative regarding device models available in your geography.
PMOP in nominally programmed Off and becomes operational when the pacing mode is programmed to DDDR or DDD mode. Additional programmable features include (nominal settings are shown in image below):
- Overdrive Rate – Pacing occurs at this rate for the duration of the programmed Overdrive Period.
- Overdrive Period – The duration for which pacing occurs at the Overdrive Rate.
To program this feature in pacemakers, go to Params -> Arrhythmia Interventions.
To program this feature in ICDs, go to Pacing -> Params -> Arrhythmia/Post Shock…
Programming for pacemakers (excluding EnRhythm™ and Revo MRI™)
Programming for ICDs (and EnRhythm and Revo MRI)
PMOP is programmable only if the Mode Switch feature is enabled.
PMOP extends Mode Switch through a period of overdrive atrial pacing following the termination of an AT/AF episode. It gradually increases the pacing rate by decreasing the pacing interval in milliseconds per pulse, until the programmed overdrive rate has been reached. PMOP then continues DDI(R) pacing at the overdrive rate. When the Overdrive Period expires, the rate is gradually modulated until the lower rate or sensor rate is reached and the pacemaker switches back to the programmed mode.
Note in this tracing that PMOP begins upon completion of Mode Switch operation.
In addition to PMOP, the device provides two other atrial intervention pacing features: Atrial Preference Pacing (APP) and Atrial Rate Stabilization (ARS).
- Device remains in DDIR while PMOP pacing.
- Since the device remains in DDI(R) mode during PMOP operation, programming PMOP On may lead to increased right ventricular pacing in patients who experience frequent paroxysmal AT or AF episodes.
Sources: Medtronic Adapta™/Versa™/Sensia™ Reference Guide; Medtronic Consulta™ CRT-P Clinician Manual;Medtronic Protecta™ XT DR Clinician Manual; Medtronic Protecta™ XT CRT-D Clinician Manual.