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Related Experiment Videos

Endless loop tachycardia in an AV universal [DDD] pacemaker.

S Furman, J D Fisher

    Pacing and Clinical Electrophysiology : PACE
    |July 1, 1982
    PubMed
    Summary
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    A pacemaker-mediated tachycardia occurred after a premature ventricular contraction. Applying a magnet to the pacemaker temporarily stopped the tachycardia by blocking signals.

    Area of Science:

    • Cardiology
    • Biomedical Engineering
    • Electrophysiology

    Background:

    • Pacemaker implantation is a common procedure for cardiac rhythm management.
    • Atrioventricular (AV) universal (DDD) pacemakers stimulate and sense both the atrium and ventricle.
    • Pacemaker-mediated tachycardia (PMT) is a potential complication of pacemaker use.

    Observation:

    • A patient with a DDD pacemaker developed a PMT.
    • The PMT was initiated by a P wave following a premature ventricular contraction (PVC).
    • Sustained tachycardia was due to retrograde AV conduction generating P waves.

    Findings:

    • The PMT was sustained by retrograde conduction from the ventricle to the atrium.
    • Application of a magnet to the pulse generator terminated the tachycardia.

    Related Experiment Videos

  • Magnet application rendered the pacemaker insensitive to P waves and QRS complexes, interrupting the circuit.

    • Implications:

    • This case highlights a specific mechanism of PMT in DDD pacemaker patients.
    • Understanding PMT mechanisms is crucial for effective pacemaker programming and patient management.
    • Magnet application serves as a useful diagnostic and temporary therapeutic tool for PMT.