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Pacemaker-mediated tachycardia in a biventricular pacing system.
B M Van Gelder1, F A Bracke, A Meijer
1Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
Pacing and Clinical Electrophysiology : PACE
|January 31, 2002
Summary
A patient experienced pacemaker tachycardia due to T wave oversensing from the right ventricular lead. This highlights a potential complication in biventricular pacing system adjustments.
Area of Science:
- Cardiology
- Biomedical Engineering
- Electrophysiology
Background:
- Biventricular pacing systems are used for patients with heart failure and atrial fibrillation.
- Standard DDDR pacemakers can be adapted for biventricular pacing by utilizing specific lead placements.
Observation:
- A 63-year-old male patient with chronic atrial fibrillation and heart failure underwent biventricular pacing system implantation.
- The system utilized a standard DDDR pacemaker, with the atrial channel for the right ventricular lead and the ventricular channel for the left ventricular lead.
Findings:
- During pacemaker parameter adjustment, pacemaker tachycardia was triggered.
- The tachycardia was caused by T wave oversensing originating from the right ventricular lead.
Implications:
- T wave oversensing is a critical factor to consider during pacemaker programming.
- Careful adjustment of pacing parameters and lead sensitivity is essential to prevent pacemaker-induced tachycardia.
- This case underscores the importance of thorough testing and optimization of biventricular pacing systems.