Dual chamber pacemakers use two thin lead wires, one placed in the right atrium and one in the right ventricle
(see above). “Dual chamber” means the lead wires are placed in two different chambers of the heart. You may
also hear the term “AV Sequential” which is the same as dual pacemaker. It paces at a programmed rate in the
atrium and senses and paces in the ventricle. This allows a more physiological response for pacing in either
of the two chambers. It monitors the heart’s native rhythm and paces the heart when the rate falls below a set value.
This is also called “on demand” pacing, and paces the heart as needed according to the set programming.
Many pacemakers use a sensor to automatically adapt the signal transmission rate to the patient’s physical
activity. The sensor reacts to various physical stress levels when a patient runs, swims or works—and prompts
the pacemaker to start pacing at an increased heart rate. The newest generation of BIOTRONIK pacemakers can
also respond to emotional stress, such as when you are watching a thrilling movie or when something
unexpected happens and your heart rate accelerates and blood pressure increases.
Below shows an example of an AV pacemaker pacing "on demand".
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