Pacemaker mediated tachycardia: Difference between revisions

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*The electrocautery device in the operating room may generate electromechanical signals that may be oversensed by the pacemaker
*The electrocautery device in the operating room may generate electromechanical signals that may be oversensed by the pacemaker


==Disorders from Which Pacemaker Mediated Tachycardia Must Be Differentiated From===
==Disorders from Which Pacemaker Mediated Tachycardia Must Be Differentiated==
*Tracking an atrial tachyarrhythmia by the dual chamber pacemaker
*Tracking an atrial tachyarrhythmia by the dual chamber pacemaker



Revision as of 23:53, 4 August 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: PMT, endless loop tachycardia,

Overview

Pacemaker mediated tachycardia is a condition in which an artificial implanted pacemaker stimulates the the ventricles (the lower chambers of the heart) to beat at rates that are inappropriately fast.

Pathophysiology

Pacemaker mediated tachycardia is a form of AV nodal reentrant tachycardia. In PMT, the artificial pacemaker forms the anterograde (atrium to ventricle) limb of the circuit and the atrioventricular (AV) node forms the retrograde limb (ventricle to atrium) of the circuit.

Causes

  • The rate response setting of the pacemaker is set too sensitive
  • Tracking of noise in the atrium as can occur with electromagnetic interference
  • The electrical activity or myopotentials from the chest wall muscles may stimulate the pacer
  • The electrocautery device in the operating room may generate electromechanical signals that may be oversensed by the pacemaker

Disorders from Which Pacemaker Mediated Tachycardia Must Be Differentiated

  • Tracking an atrial tachyarrhythmia by the dual chamber pacemaker

Diagnosis

Symptoms

The majority of patients are asymptomatic. Some patients may complain of the following:

Physical Examination

Vital Signs

Neck

Chest

  • The pacemaker is present

Electrocardiogram

There is a ventricular-paced rhythm at or near the upper rate limit at approximately 120-130 beats per minute. given the mechanical nature of the trigger, the EKG is absolutely regular.

Treatment

The pacemaker can be turned off by placing a magnet over it. The treatment of PMT typically involves reprogramming the pacemaker.

References

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