Related Experiment Video
Updated: Aug 5, 2026
12:45
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Pacemaker Syndrome: A Narrative Review
Muhammad Asad1, Kubra Khaliq2, Asif Shah3
1Fellow, Royal Brompton Hospital, London, UK.
Pacing and Clinical Electrophysiology : PACE
|August 4, 2026
Summary
Pacemaker syndrome, caused by improper heart rhythm timing, leads to various symptoms. Restoring atrioventricular synchrony through device adjustments is key for managing this condition.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Cardiac pacing has revolutionized bradyarrhythmia management since 1958.
- Pacemaker therapy can lead to pacemaker syndrome due to atrioventricular (AV) dyssynchrony.
Purpose of the Study:
- To define pacemaker syndrome, its pathophysiology, clinical manifestations, and management strategies.
- To highlight the importance of AV synchrony in pacemaker therapy.
Main Methods:
- Clinical diagnosis based on symptoms, pacemaker interrogation, and electrocardiography.
- Review of pathophysiology involving impaired hemodynamics and neurohormonal responses.
- Analysis of management strategies including device reprogramming and upgrades.
Main Results:
- Pacemaker syndrome presents with diverse cardiovascular and neurologic symptoms.
- Incidence varies widely (2-80%) depending on pacing mode and diagnostic criteria.
- Pathophysiology includes reduced ventricular preload and loss of atrial contribution.
Conclusions:
- Pacemaker syndrome can occur with any pacing modality if AV synchrony is disrupted.
- Management focuses on restoring AV synchrony to improve patient outcomes.
- Early recognition and intervention are crucial to prevent long-term complications like ventricular dysfunction and reduced quality of life.
Related Concept Videos
01:30Pulse rhythm
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
01:25Dysrhythmias VI: Management of Dysrhythmias
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
01:15Dysrhythmias I: Introduction
Dysrhythmias refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
01:30Acute Coronary Syndrome I: Introduction
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
01:28Mechanism of Cardiac Arrhythmias
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
01:19Electrophysiology of Normal Cardiac Rhythm
The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase of...