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KMID : 0368120000300030334
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Korean Circulation Journal
2000 Volume.30 No. 3 p.334 ~ p.338
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Three Cases of Pacemaker-Mediated Tachycardia
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이계원/Kae Won Lee
조정휘/김우식/강흥선/김권삼/송정상/배종화/Chung Whee Choue/Woo Sik Kim/Heung Sun Kang/Kwon Sam Kim/Jung Sang Song/Jong Hoa Bae
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Abstract
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Pacemaker-mediated tachycardia (PMT) is a well-known complication of dual-chamber
pacemaker with atrioventricular sensing and pacing(DDD) or atrial synchronous,
ventricular demand pacemaker(VDD). PMT usually starts with sensing a retrograde P
waves linked to ventricular extrasystole with retrograde ventriculoatrial conduction and
forms reentrant or circus movement tachycardia with the pacemaker itself as an
antegrade limb and the conducting tissue of the heart as a retrograde limb. Recently, a
number of pacemaker manufactures have incorporated in their divices a variety of
relatively complex algorithms to prevent PMT. Despite these measures, PMT may still
occur because of inappropriate programming or unpredictable variations of ventriculoatrial
conduction. We report two cases of PMT in 78 year-old man and 60 year-old man who
had suffered DDD type pacemakers due to sick sinus syndrome, and a case of PMT in
69 year-old man who had suffered complete heart block and received a VDD type
pacemaker. In these cases, we investigate symptoms, mechanism of PMT, programed
parameters of pacemaker and treatments of PMT.
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