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Pacemaker mediated tachycardia as a complication of the autointrinsic conduction search function
Malcolm J Dennis1, Paul B Sparks
1Intensive Care Unit, Epworth Hospital, Melbourne, Australia. malcolmd@epworth.org.au
Pacing and Clinical Electrophysiology : PACE
|June 11, 2004
Summary
The autointrinsic conduction search (AICS) feature on DDD pacemakers can trigger pacemaker-mediated tachycardia (PMT) by enabling retrograde ventriculoatrial conduction. This case highlights the need for prevention strategies during AICS activation.
Area of Science:
- Cardiology
- Biomedical Engineering
- Electrophysiology
Background:
- DDD pacemakers utilize the autointrinsic conduction search (AICS) to assess and prolong atrioventricular (AV) conduction.
- AICS allows for extended AV delays when intrinsic ventricular conduction is present, optimizing pacemaker function.
Observation:
- A specific case demonstrated retrograde ventriculoatrial conduction during AICS.
- This retrograde conduction precipitated pacemaker-mediated tachycardia (PMT) seven times in a single patient.
Findings:
- The wide separation between atrial and ventricular pacing during the AICS was identified as the cause of retrograde conduction.
- Two distinct patterns of PMT onset were observed, both linked to the AICS function.
Implications:
- The findings necessitate the development of preventative strategies to mitigate PMT risk associated with AICS.
- Clinicians should be aware of the potential for PMT during AICS activation in DDD pacemaker patients.