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  • Title: Pacemaker-mediated tachycardias: an unresolved problem.
    Author: Harthorne JW, Eisenhauer AC, Steinhaus DM.
    Journal: Pacing Clin Electrophysiol; 1984 Nov; 7(6 Pt 2):1140-7. PubMed ID: 6209649.
    Abstract:
    The advent of dual chamber pacing systems that restore atrioventricular synchrony and allow rate variability in response to physiologic stress has provided a major advance in pacing therapy. Undesirable pacemaker-mediated tachycardias may arise when the atrial sensing amplifier of a VDD or DDD device detects a retrogradely conducted P-wave, ectopic atrial tachycardia, myopectoral contractions, or environmental electromagnetic interference. The rate of the resultant tachycardia is determined by the programmed upper tracking rate of the pacemaker. Although seldom life-threatening, troublesome myocardial ischemia may ensue in patients with coronary artery disease. In most instances, the incidence and rate of pacemaker-mediated tachycardias may be minimized by judicious programming.
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