z-logo
Premium
Pacemaker Syndrome in a Patient with DDD Pacemaker for Long QT Syndrome
Author(s) -
CHIEN WALTER W.,
FOSTER ELYSE,
PHILLIPS BARRY,
SCHILLER NELSON,
GRIFFIN JERRY C.
Publication year - 1991
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.1540-8159.1991.tb02856.x
Subject(s) - medicine , cardiology , refractory period , anesthesia
A patient with long QT syndrome was treated with bela blockers and had a permanent DDD pacemaker implanted. The lower rate was set to 85 beats/min because this provided the best shortening of QT interval at the lowest paced heart rate. The atrioventricular (AV) delay was programmed to 250 msec to allow native AV conduction. Patient returned complaining of symptoms suggestive of pacemaker syndrome. EGG during one of these episodes showed AV sequential pacing. Doppler echocardiography of hepatic vein flow suggested atrial contraction against a closed tricuspid valve. Endocardial electrogram telemetry demonstrated ventriculoatrial (VA) conduction with the retrograde atrial electrogram falling within the atrial re/ractory period and thus was not sensed. The following atrial stimulus did not capture because of the atrial refractoriness. Ventricular pacing proceeded after the programmed AV delay. Reprogram‐ming the AV delay to 200 msec restored AV synchrony by allowing the atrial stimulus to capture by placing it outside of the refractory period of the atrium. No further symptoms reported during six months of follow‐up.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here