Skip to main content
Article thumbnail
Location of Repository

Automatic Mode Switching in Atrial Fibrillation

By Stabile Giuseppe, Simone Antonio De and Romano Enrico


Automatic mode switching (AMS) algorithms were designed to prevent tracking of atrial tachyarrhythmias (ATA) or other rapidly occurring signals sensed by atrial channels, thereby reducing the adverse hemodynamic and symptomatic consequences of a rapid ventricular response. The inclusion of an AMS function in most dual chamber pacemaker now provides optimal management of atrial arrhythmias and allows the benefit of atrioventricular synchrony to be extended to a population with existing atrial fibrillation. Appropriate AMS depends on several parameters: a) the programmed parameters; b) the characteristics of the arrhythmia; c) the characteristics of the AMS algorithm. Three qualifying aspects constitute an AMS algorithm: onset, AMS response, and resynchronization. Since AMS programs also provide data on the time of onset and duration of AMS episodes, AMS data may be interpreted as a surrogate marker of ATAs recurrence. Recently, stored electrograms corresponding to episodes of ATAs have been introduced, thus clarifying the accuracy of AMS in detecting ATAs Clinically this information may be used to assess the efficacy of an antiarrhythmic intervention or the risk of thromboembolic events, and it may serve as a valuable research tool for evaluating the natural history and burden of ATAs

Topics: Indian Pacing and Electrophysiology Journal
Publisher: Indian Pacing and Electrophysiology Group
Year: 2005
OAI identifier:

Suggested articles


  1. Accuracy of mode switch algorithms for detection of atrial tachyarrhythmias. doi
  2. (2002). Analysis of mode switching algorithms in dual chamber pacemakers. Pacing Clin Electrophysiol
  3. (1992). Atrial arrhythmias in dual chamber pacing and their influence on long-term mortality. Pacing Clin Electrophysiol
  4. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke. Report of the Atrial Diagnostics Ancillary Study of the Mode Selection Trial (MOST).
  5. (2002). Automatic mode switching of implantable pacemakers: I. Principles of instrumentation, clinical, and hemodynamic consideration. Pacing Clin Electrophysiol
  6. Automatic mode switching of implantable pacemakers: II. Clinical performance of current algorithms and their programming.
  7. Clinical utility of intraatrial pacemaker stored electrograms to diagnose atrial fibrillation and flutter. Pacing Clin Electrophysiol 2001;24P t.1:424- doi
  8. (2000). Detection of atrial fibrillation and flutter by a dual-chamber implantable cardioverterdefibrillator. For the Worldwide Jewel AF Investigators. Circulation
  9. (1997). Failure of automatic mode switching: recognition and management. Pacing Clin Electrophysiol
  10. (2005). Importance of ventricular rate after mode switching during low intensity exercise as assessed by clinical symptoms and ventilatory gas exchange. Pacing Clin Electrophysiol 2000;23:32-39.
  11. (1996). Incidence of atrial arrhythmia in patients with long term dual-chamber pacemakers. Arch Mal Coeur Vaiss
  12. (1997). Is mode switching beneficial: A randomized study in patients with atrial tachyarrhythmias.
  13. Long-term risk of recurrent atrial fibrillation as documented by an implantable monitoring device. doi
  14. (2005). Management of atrial tachyarrhythmias: Benefits of pacemakers diagnostics. doi
  15. Mode switching failure during atrial flutter: the “2:1 lock-in” phenomenon.
  16. Pacemakers systems as implantable cardiac rhythm monitors.
  17. (1998). Prevalence of supraventricular arrhythmias from the automatic analysis of data stored in the DDD pacemakers of 617 patients: The AIDA study. Pacing Clin Electrophysiol
  18. (1998). Programmed atrial sensitivity: A critical determinant in atrial fibrillation detection and optimal automatic mode switching. Pacing Clin Electrophysiol
  19. (1994). Reason for reprogramming dual chamber pacemakers to VVI mode: a retrospective review using a computer database. Pacing Clin Electrophysiol doi
  20. (2002). Selection of endpoints in atrial fibrillation studies.
  21. (2005). Specificity of atrial mode switching in detecting atrial fibrillation episodes: Roles of length and continuity. Pacing Clin Electrophysiol doi

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.