title: Unusual VDD-pacing.
abstract: The case of an 80-year-old woman who underwent permanent VDD-pacemaker implantation for recurrent syncope in the presence of second-degree type 2 AV-block is reported. During follow-up, low atrial sensing with AV-synchrony of only 58-73% was noted. Four years after the pacemaker implantation, the patient was hospitalized for non-cardiac reasons and the chest radiograph showed displacement of the atrial dipole into the right ventricular outflow tract (RVOT). It is hypothesized that AV-synchrony was maintained by left atrial sensing due to the anatomic proximity of the RVOT to the left atrial appendage.
authors.affiliation: Cardiology Division, Internal Medicine University Department, Kantonsspital Bruderholz, H-4101 Bruderholz, Switzerland.
authors.forename: Jörg
authors.initials: J
authors.lastname: Schumann
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kiencke
authors.forename: Stefan
authors.initials: S
authors.lastname: Osswald
authors.forename: Peter
authors.initials: P
authors.lastname: Rickenbacher
mesh_terms: D000369:Aged, 80 and over; D004562:Electrocardiography; D004567:Electrodes, Implanted / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006327:Heart Block / Q000628:therapy; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D013575:Syncope / Q000209:etiology; D018754:Ventricular Dysfunction / Q000503:physiopathology*