Pacemaker-mediated polymorphic ventricular tachycardia

A patient with refractory bradycardia dependent polymorphic ventricular tachycardia (PMVT) underwent permanent pacemaker placement for suppression of her arrhythmia. Following implant, the patient had recurrent PMVT. Interrogation of the device revealed a factory programmed feature (+ PVARP on PVC) designed to prevent pacemaker-mediated tachycardia that led to cycle length variability and subsequent arrhythmia recurrence. This feature was deactivated and the patients' arrhythmia did not recur.