Pacemaker-mediated tachycardia induced by left ventriculography during diagnostic catheterisation: a rare event

Pacemaker-mediated tachycardia (PMT) is an arrhythmia seen in patients implanted with dual-chamber pacemakers. It occurs when ventricular contraction is followed by retrograde conduction to the atrium, which is sensed by the pacemaker, leading to ventricular triggering. A vicious re-entry cycle is set up, leading to incessant tachycardia unless appropriately terminated. A common precipitant is a premature ventricular contraction (PVC). Although PVCs are frequently generated during ventriculography, PMT is an extremely rare event during cardiac catheterisation despite the fact that a large number of patients with implanted pacemakers do undergo the procedure. We report on a case and hope to highlight the possibility of PMT occurring during catheterisation, as well on therapeutic options.