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Magnet unresponsive pacemaker endless loop tachycardia.

S S Barold¹, M D Falkoff, L S Ong

¹Department of Medicine, Genesee Hospital, Rochester, NY 14607.

American Heart Journal

|September 1, 1988

Summary

This summary is machine-generated.

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Endless loop tachycardia (ELT) is a pacing complication. Chest wall stimulation can terminate magnet-nonresponsive ELT when DDD pacing converts to AV desynchronization.

Area of Science:

Cardiology
Biomedical Engineering
Electrophysiology

Background:

Dual-chamber (DDD) pacing can lead to endless loop tachycardia (ELT), a common complication.
Magnet application typically terminates ELT by converting pacing to asynchronous mode (DOO).

Observation:

Magnet application may fail to terminate ELT if ventriculoatrial (VA) synchrony converts to atrioventricular (AV) desynchronization.
This desynchronization occurs when paced ventricular beats trigger unsensed retrograde P waves, leading to ineffective atrial stimuli during the refractory period.

Findings:

Magnet-unresponsive ELT involves a self-perpetuating VA synchrony due to AV desynchronization.
Upon magnet removal, the AV desynchronization reverts to ELT.

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Implications:

Chest wall stimulation offers a practical, non-invasive method to terminate magnet-unresponsive ELT in the absence of programmers.
This technique provides a crucial alternative for managing refractory pacing-induced arrhythmias.