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KMID : 1011920090100030039
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International Journal of Arrhythmia
2009 Volume.10 No. 3 p.39 ~ p.42
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A case of pacemaker-mediated tachycardia treated by increasing the atrial refractory period instead of increasing the postventricular atrial refractory period
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Jang Sung-Won
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Abstract
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Pacemaker-mediated tachycardia is a form of reentrant tachycardia that has been observed and understood after the introduction of dual-chamber pacing. In this setting, the antegrade limb of the circuit is formed by the pacemaker and the retrograde limb is the intrinsic atrioventricular (AV) node (conduction from the ventricle to the atrium). We report a patient who presented with pacemaker-mediated tachycardia. Pacemaker-mediated tachycardia is usually treated with increasing the postventricular atrial refractory period (PVARP). In the present case, tachycardia was successfully eliminated by shortening of the atrioventricular interval (AVI) instead of modulating PVARP. Decreasing the AVI resulted in a loss of retrograde atrial capture and the patient could maintain sinus rhythm with ventricular pacing.
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KEYWORD
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pacemaker-mediated tachycardia, endless-loop tachycardia
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