Linking as the cause of unnecessary right ventricular pacing.
BACKGROUND
The current report describes a manifestation of linking phenomenon in DDD pacemaker recipients: impairment of atrioventricular (AV) conduction and ensuing unnecessary right ventricular (RV) pacing.


METHODS
Three patients with second-degree AV block and sudden impairment of native AV conduction following pacemaker implantation are presented. Loss of native AV conduction was considered functional and related to repetitive retrograde invasion of ventricular depolarization to the AV junction that was "linked" to ventricular pacing triggered by nonconducted P-waves.


CONCLUSIONS
This case series demonstrates that linking phenomenon should be considered in analysis of pacemaker behavior, and that retrograde concealment can be responsible for unnecessary RV pacing.
Jastrzebski
Marek
M
I Department of Cardiology and Hypertension, University Hospital, Krakow, Poland. mcjastrz@cyf-kr.edu.pl
D000368:Aged; D000465:Algorithms; D054537:Atrioventricular Block / Q000209:etiology* / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects*