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Pacemaker‐Mediated Tachycardia: Manufacturer Specifics and Spectrum of Cases
Author(s) -
MONTEIL BENJAMIN,
PLOUX SYLVAIN,
ESCHALIER ROMAIN,
RITTER PHILIPPE,
HAISSAGUERRE MICHEL,
KONERU JAYANTHI N.,
ELLENBOGEN KENNETH A.,
BORDACHAR PIERRE
Publication year - 2015
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/pace.12750
Subject(s) - medicine , cardiology , tachycardia , refractory period , atrial tachycardia , ventricular tachycardia , atrial fibrillation , catheter ablation
Pacemaker‐mediated tachycardia (PMT) is the term used to describe a repetitive sequence of sensed retrograde P waves followed by ventricular pacing at or below the maximum tracking rate. The following events can promote atrioventricular (AV) dissociation, retrograde conduction, and the onset of PMT: ventricular or atrial extrasystole, an excessively long programmed AV delay, external interference or myopotentials sensed by the atrial channel, atrial sensing or pacing failure, the absence of postventricular atrial refractory period extension after removal of a magnet, and VDD pacing at a higher rate than sinus rate. In contemporary devices, each manufacturer has a proprietary algorithm to detect and terminate PMT. Because of the increase in the number and complexity of the pacing algorithms and because of manufacturer‐driven differences, a basic understanding of these new algorithms is important for patient care. We review here the main elements of the physiopathology of this type of tachycardia, describe the specific characteristics of the different manufacturers, and present representative clinical cases.