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DDD‐Pacemaker Pseudomalfunction During Supraventricular Tachycardia
Author(s) -
FONTAINE JOHN M.,
ALMAPERRI CARMEN,
ELSHERIF NABIL
Publication year - 1988
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1988.tb04984.x
Subject(s) - medicine , refractory period , reversion , cardiology , qrs complex , effective refractory period , supraventricular tachycardia , tachycardia , anesthesia , refractory (planetary science) , biochemistry , chemistry , physics , astrobiology , gene , phenotype
Asynchronous pacing during the presence of electromagnetic interference or other sources of “noise” is a protective mechanism available to prevent pacemaker output inhibition. We describe a patient with a DDD pacemaker who had asynchronous dual chamber or noise reversion pacing as a consequence of repetitive signals (QHS complexes) failing into the noise sampling period (NSP) of the pacemaker ventricular refractory period. During supraventricular tachycardia al a rate of 215 bpm, noise reversion mode pacing occurred when QRS complexes were well detected immediately after the termination of a normal pacemaker ventricular refractory period and treated as a premature ventricular depolarization, resulting in automatic refractory period extension. Recycling of this extended refractory period occurred when consecutive QRS complexes were detected during the NSP and forced asynchronous dual chamber pacing at the programmed lower rate. The mechanism is presented and was supported by subthreshold esophageal pacing simulating the tachycadia and initiating the noise reversion response.