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A case of pacemaker and pacemaker-like syndrome
Amir Kashani1, Ali Mehdirad, Carey Fredman
1Rochester General Hospital, Rochester, NY 14621, USA. AHK3@AOL.COM
Summary
Pacemaker syndrome and pseudopacemaker syndrome occurred in a patient with junctional rhythm due to sick sinus syndrome. Symptoms were similar, linked to retrograde conduction, and reproducible with pacing.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Technology
Background:
- Sick sinus syndrome can lead to arrhythmias like atrioventricular junctional rhythm.
- Pacemaker syndrome and pseudopacemaker syndrome present with similar clinical and hemodynamic issues.
- Retrograde ventriculoatrial conduction is a key factor in these syndromes.
Observation:
- A patient with sick sinus syndrome developed an atrioventricular junctional rhythm.
- This patient experienced both pacemaker syndrome and pseudopacemaker syndrome.
- Clinical manifestations were identical in both conditions, linked to regular retrograde conduction.
Findings:
- The patient's junctional rhythm mimicked symptoms seen during ventricular pacing.
- Hemodynamic abnormalities observed during junctional rhythm were reproduced by ventricular pacing.
- Pseudopacemaker syndrome during junctional rhythm is rare in patients with normal left ventricular function.
Implications:
- This case highlights the overlap in presentation between pacemaker syndrome and pseudopacemaker syndrome.
- Understanding retrograde conduction is crucial for diagnosing and managing these pacing-related complications.
- Further research is needed on the mechanisms of pseudopacemaker syndrome in non-paced rhythms.