AI Article Synopsis
- A 25-year-old runner was fitted with a VDD pacemaker after treatment for a heart rhythm issue and experienced intermittent heart block.
- The pacemaker was programmed with a rate-adaptive AV delay algorithm to adjust the heart's rhythm during exercise, which led to a specific type of repetitive tachycardia (PMT) due to abnormal conduction pathways.
- High-density electroanatomic mapping was used successfully to isolate and ablate the abnormal conduction route causing the PMT without affecting normal heart function.
Article Abstract
A 25-year-old runner received a single-lead, VDD pacemaker after ablation of AV nodal reentrant tachycardia complicated by intermittent AV block. The rate-adaptive AV delay algorithm (RAAV), which shortens the sensed AV interval (SAV) at faster atrial rates, was programmed to provide a physiologic SAV with exercise. She developed repetitive, atypical, long-RP pacemaker-mediated tachycardia (PMT) because the RAAV shortened the antegrade SAV and retrograde conduction occurred over the slow AV nodal pathway. PMT was refractory to usual programming solutions. Using high-density electroanatomic mapping, we were able to ablate the retrograde limb of PMT without further damaging AV conduction.
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| http://dx.doi.org/10.1111/jce.14424 | DOI Listing |
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