Pacemaker-mediated tachycardia induced by left ventriculography during diagnostic catheterisation: a rare event.
Pacemaker-mediated tachycardia (PMT) is an arrhythmia seen in patients implanted with dual-chamber pacemakers. It occurs when ventricular contraction is followed by retrograde conduction to the atrium, which is sensed by the pacemaker, leading to ventricular triggering. A vicious re-entry cycle is set up, leading to incessant tachycardia unless appropriately terminated. A common precipitant is a premature ventricular contraction (PVC). Although PVCs are frequently generated during ventriculography, PMT is an extremely rare event during cardiac catheterisation despite the fact that a large number of patients with implanted pacemakers do undergo the procedure. We report on a case and hope to highlight the possibility of PMT occurring during catheterisation, as well on therapeutic options.
Jafary
Fahim H
FH
Department of Medicine, Section of Cardiology, Aga Khan University Hospital, Karachi, Pakistan.
Shafquat
Azam
A
D054058:Acute Coronary Syndrome / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D054537:Atrioventricular Block / Q000097:blood / Q000000981:diagnostic imaging; D006328:Cardiac Catheterization / Q000009:adverse effects; D015637:Gated Blood-Pool Imaging / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011859:Radiography; D013610:Tachycardia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*