Atrial Systole and Ineffective Pacemaker Stimuli (original) (raw)
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Pacing and Clinical Electrophysiology, 1985
A cause of atrial malpacing in AV universal pacemakers. A report of two cases. Hetrognid)! atrial activation during venlricuiur pocing has ojlen been a caust' of inlermiflont or persislenl arrhylhmios (pacemaker-mediated tochycardia) in AV universaJ pacemakers. We recen(/y encountered (wo cases in which VA conduction was responsibie for atrial mciJpncing in jKid'enfs with an implantf.d AV universal pncnmaker. oiw programmed in DDD and one in DVl mode. Atrial nialpacing was induced by the alrial refvactoriness due to retrograde actjvotjon. In the first patient, it was observed when the pacemaker was programmed to a rale of 110 ppm {lower rate] and an AV interval of 200 ms in order to cbeck crosstalk. In the second patient, it was observed after ventricular premature contractions.
Pacing and Clinical Electrophysiology, 1982
Pacer-induced tachycardia associated with an atriaJ synchronous ventricuiar inhibited (ASVIP) pulse generator. A 68-year-old white maJe underwent permanent pacemaker impiantation with an atrial synchronous ventricular inhibited pulse generator fMedtronic modei 2409} because of syncope and abnormal H-V interval of 70 ms. Paroxysmal bouts of pacemaker associated tachycardia were subsequently recorded on several occasions, initiated and terminated by spontaneous ventricular premature beats. The mechanism for the occurrence of the tachyarrhythmia is discussed in detail and the functional characteristics of the pulse generator are described. Replacement of the unit with a different pacer device prevented further occurrence of the arrhythmia. (PACE, Vol. 5, March-Aprii, 1982] pacer tachycardia, atriaJ synchronous pacer, pacemaker arrhythmia, programmable pacemaker, retrograde conduction The development of more stable transvenous atrial electrodes and improved surgical implantation techniques'"^ has rekindled interest in the use of dual chamber pulse generators, both for hemodynamic benefit""'" as well as antiarrhythmic effect.""'* As a result, more complex pacemaker electrocardiograms have emerged and more often than not, have posed a problem in their correct interpretation. Recently, we treated a patient who presented with an interesting pacemaker associated arrhythmia.
Atypical pacemaker-mediated tachycardia from the atrial channel: What is the mechanism?
Heart Rhythm, 2011
A 79-year-old woman with history of hypertension, dyslipidemia, obesity, bulbar stroke , and paroxysmal atrial fibrillation was evaluated for an abrupt syncope. Echocardiogram showed no abnormalities, and Holter monitoring showed sinus arrhythmia with right bundle branch block (RBBB) and signs of sick sinus syndrome due to significant pauses. A dual-chamber pacemaker was implanted without complications (ventricular electrode in the right ventricular apex and atrial electrode at the high right atrial appendage). Pacemaker settings were DDDR mode, basic rate 65 bpm, maximum sensor rate 110 bpm, maximum tracking rate 150 bpm, and dynamic AV interval of maximum 280/minimum KEYWORDS Pacemaker-mediated tachycardia; electrodes dislodgement ABBREVIATIONS ECG ϭ electrocardiogram; PMT ϭ pacemaker-mediated tachycardia; RBBB ϭ right bundle branch block (Heart Rhythm 2011;8:636 -638)
Ventricular Output Failure in a DDD Permanent Pacemaker Associated with Increased Atrial Output
Pacing and Clinical Electrophysiology, 1997
Previous reports have described the occurrence of ventricular autput failure in a permanent DDD pacemaker system related to an increase in the atrial output in the presence of low atrial lead impedance (Medtronic Synergyst®/Synergyst II®). This phenomenon is seen exclusively following atrial paced events and may potentially lead to significant bradyarrhythmia or ventricular asystole in a pacemaker dependent patient. We describe the occurrence of analogous behavior in a Medtronic Symbios® 7006 generator.
Pacemaker‐mediated arrhythmias
Journal of Arrhythmia
Pacemakers can be directly involved in initiating or sustaining different forms of arrhythmia. These can cause symptoms such as dyspnea, palpitations, and decompensated heart failure. Early detection of these arrhythmias and optimal pacemaker programming is pivotal. The aim of this review article is to summarize the different types of pacemaker-mediated arrhythmias, their predisposing factors, and mechanisms of prevention or termination. K E Y W O R D S endless loop tachycardia, pacemaker-mediated arrhythmia, retrograde ventriculo-atrial conduction This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Pacemaker-mediated tachycardias: a new modality of treatment
Pacing and clinical electrophysiology : PACE, 1984
Three patients with pacemaker interactive drug resistant tachycardia underwent invasive electrophysiological studies. In the first patient, the retrograde conduction of the artificial reciprocating tachycardia was provided by two right-sided accessory pathways and the antegrade conduction by an atrial synchronous pulse generator. In addition, AV-nodal tachycardia occurred alternately. In the second patient with intermittent atrial flutter, the AV node and, coincidentally, an AV sequential pulse generator provided high-rate antegrade conduction to the ventricles. In the third patient with surgical complete heart block, intermittent AV-nodal tachycardia induced retrograde atrial activation while an atrial synchronous pacemaker provided the antegrade conduction. Electrode catheter exploration of the heart allowed localization and closed-chest ablation of the accessory pathways or AV node by delivering two to seven 200-joule direct-current shocks through the appropriate electrode of the...