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QT‐Related Rate‐Responsive Pacing During Acute Myocardial Infarction
Author(s) -
ROBBENS ERWIN J.,
CLEMENT DENIS L.,
JORDAENS LUC J.
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.tb05014.x
Subject(s) - medicine , atropine , qt interval , myocardial infarction , cardiology , adrenergic , anesthesia , heart rate , cholinergic , coronary artery disease , stimulation , electrocardiography , blood pressure , receptor
We studied the findings in a patient who had a TX 915 pacemaker and who was suffering from an acute inferior myocardial infarction. On admission, we observed pacing at the upper rate limit due to excessive adrenergic tone. Shortly thereafter a strong vagal reaction occurred, and the pacing rate fell back to the lower rate limit. This condition was improved with atropine. Conclusions: (1) In the described condition the TX pacemaker behaved in a very “physiological” fashion; (2) Sudden strong cholinergic activity lengthened the QT interval; (3) Programming of a steep slope must be avoided in coronary artery disease; (4) Stimulus‐ T‐wave intervals at maximal adrenergic and cholinergic stimulation should be taken into account when programming the slope and the T‐wave sensing window.