Open AccessThe pacemaker syndrome: Old and new causes
Author(s) -
Schüller H.,
Brant J.,
Camm A. J.
Publication year - 1991
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960140410
Subject(s) - medicine , sick sinus syndrome , cardiology , atrioventricular block , bradycardia , atrioventricular node , anesthesia , heart block , electrocardiography , blood pressure , heart rate , tachycardia
The pacemaker syndrome refers to symptoms and signs in the pacemaker patient caused by inadequate timing of atrial and ventricular contractions. The lack of normal atrioventricular synchrony may result in decreased cardiac output and venous “cannon A waves.” A sudden increase in atrial pressure at the onset of asynchrony may elicit a systemic hypotensive reflex response. A wide range of symptoms can be observed. The pacemaker syndrome is encountered in a significant number of patients with ventricular (VVI) pacemakers, mostly when 1:1 retrograde ventriculoatrial conduction is present. The risk of occurrence of the pacemaker syndrome is minimized if pacemaker systems are used which restore or maintain the normal atrioventricular contraction sequence. Hence, in sinus node disease, atrial stimulation with or without ventricular stimulation should be employed, while in high‐grade atrioventricular block dual‐chamber pacing is recommended. The pacemaker syndrome is not restricted to the VVI stimulation mode. It can be seen, though rarely, in atrial and dual‐chamber pacing, and an awareness of these new causes is necessary. An established pacemaker syndrome can often be counteracted by adjusting the pulse generator function.