Pacemaker‐mediated tachycardia with narrow QRS complexes

Abstract

Key Clinical MessageInverted connection of the atrial and ventricular leads is an unusual circumstance during the implantation of a dual‐chamber pacemaker. Yet, PMT may present in the absence of complex mechanisms. The detection and termination algorithms used by the device proved to be efficient for the adequate diagnosis and treatment.

Pacemaker‐mediated arrhythmias

“…Orthodromic PMT has also been reported following inverted connection of the atrial and ventricular leads during generator replacement or the dislodgement of the leads. In these conditions, ventricular activation is sensed by the atrial electrode as an atrial event, which then triggers a stimulus through the ventricular electrode in the atrium, which is conducted to ventricle via the intrinsic conduction system and again sensed by the atrial electrode …”