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Tachycardia-termination algorithm: a valuable feature for interruption of pacemaker-mediated tachycardia
Pacing and Clinical Electrophysiology : PACE
|March 1, 1984
Summary
Pacemaker-mediated tachycardia (PMT) can occur in patients with V-A conduction. The Intermedics Cosmos DDD-M pacemaker features a tachycardia-termination algorithm to prevent and terminate PMT.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- A 45-year-old male patient with a VVI pacemaker for sinus arrest experienced syncope and dizziness.
- Normal pacemaker function was observed, but retrograde ventriculoatrial (V-A) conduction was present during ventricular pacing.
Observation:
- Replacement with a DVI pacemaker resulted in periodic abdominal muscular contractions.
- The patient was subsequently implanted with an Intermedics Cosmos DDD-M pacemaker.
Findings:
- The DDD-M pacemaker, in patients with V-A conduction, is susceptible to pacemaker-mediated tachycardia (PMT).
- The Cosmos pacemaker incorporates a tachycardia-termination algorithm designed to detect and interrupt sustained pacing at the ventricular tracking rate, thereby breaking the reentrant loop responsible for PMT.
- This algorithm allows 15 consecutive pacing events before inhibiting the 16th ventricular output pulse, effectively terminating the tachycardia.
Implications:
- The tachycardia-termination algorithm in DDD-M pacemakers is a valuable feature for patients with V-A conduction, preventing PMT initiation and enabling termination.
- Further investigation is needed to determine the universal efficacy of this algorithm across all patient cases.