Ventricular tachycardia initiated solely by reduced pacing rate during routine pacemaker follow-up.
Ventricular arrhythmias during a pacemaker follow-up have been previously reported, usually in conjunction with temporary asynchronous stimulation of a demand pacemaker through magnet application or by increased myocardial excitability, for example, following a myocardial infarction. The subject of this report, an 82-year-old pacemaker patient, had been VVI-paced without problems for the past 11 years. As an aid in determining the sensing threshold, the pacemaker lower rate was reduced from 70 to 40 beats/min. A ventricular tachycardia of 240 beats/min was induced, most likely following short-long cycles; syncope resulted. To our knowledge, this is the first report of induction of a ventricular tachycardia during pacemaker follow-up solely by reduction of pacing rate and not by asynchronous pacing. This case demonstrates an additional potential risk associated with pacemaker rate manipulation during pacemaker follow-up.
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1. Medizinische Klinik, Klinikum rechts der Isar, Technischen Universität München, Germany.
Coenen
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Baedeker
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Schmitt
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D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D017180:Tachycardia, Ventricular / Q000209:etiology*