The electrocardiographic interpretation of ventricular pacing suppression algorithms in the pacemaker

Algorithms designed to reduce the right ventricular (RV) pacing burden are widely available in modern dual-chamber implantable pacing devices. These algorithms allow the atrioventricular delay for sensed ventricular events to be longer than for ventricular paced events. However, since these features are unique to pacemaker manufacturers, they often produce unfamiliar electrocardiographic (ECG) appearances that suggest pacemaker dysfunction. We describe a Vp suppression algorithm used in Biotronik dual-chamber pacemakers and implantable cardioverter-defibrillator devices.