"Pseudo-endless Loop" Tachycardia in an AV Universal (DDD) Pacemaker |
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| Authors: | SHLOMO AMIKAM CAROLYN ANDREWS SEYMOUR FURMAN |
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| Affiliation: | Division of Cardiothoracic Surgery, Department of Surgery, Montefiore Medical Center, Bronx, New York, and the Department of Cardiology, Rambam Medical Center, Haifa, Israel |
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| Abstract: | A 3-beat episode of ventricular arrhythmia was recorded in a patient with an AV universal (DDD) pacemaker. This arrhythmia mimicked "endless loop" tachycardia (ELT) because it appeared following a ventricular premature contraction (VPC), its rate approached the preset upper-rate limit and the regular P waves disappeared during the episode. However, as retrograde conduction was absent ELT could not exist. The mechanism of this arrhythmia was based on a combination of interference by VPC of the regular sequence of this complexes produced by P wave and the pacemaker commitment to maintain an upper rate limit by prolongation of the programmed pacemaker AV delay. |
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| Keywords: | pacemaker-mediated arrhythmias endless loop tachycardia dual-chamber pacing |
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