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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9809094PMC
http://dx.doi.org/10.14503/THIJ-21-7761DOI Listing

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Article Synopsis
  • The study explores a new type of heart rhythm issue called pseudo-RNRVAS that occurs when atrial stimulation stops while there is continued communication between the ventricles and atrium during certain heart phases.
  • Researchers investigated 21 patients with cardiac devices, finding that 20 experienced pseudo-RNRVAS, particularly at lower heart rates and specific timing intervals after losing atrial capture.
  • The findings suggest that pseudo-RNRVAS can happen without the usual risk factors and are more likely in scenarios that increase atrial pacing, especially soon after pacemaker implantation, indicating a possible link to pacemaker syndrome and heart failure risk.
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  • A 55-year-old man with nonischemic cardiomyopathy experienced a unique tachycardia recorded by an implantable cardioverter defibrillator, raising concerns about its identification and management.
  • The report outlines how to differentiate this type of tachycardia from similar heart rhythms and discusses the clinical implications related to patient care.
  • It also highlights the limitations of the device in handling these tachycardias and suggests reprogramming strategies to reduce the chances of recurrence, stressing the need for thorough analysis of device-related arrhythmias.
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Article Synopsis
  • Endless loop tachycardia (ELT) is a frequent issue in patients with implanted cardiac devices and can cause serious symptoms despite preventive measures.
  • * A study analyzed 20 cases of sustained ELT from 4,520 device checkups over four years, finding it usually benign but occasionally harmful, particularly in patients with left ventricular dysfunction.
  • * Various factors contributed to ELT, including improper AV synchrony and sensing issues, and adjustments like changing sensitivity settings or PVARP duration were necessary for management.
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Article Synopsis
  • Pacemaker-mediated tachycardia (PMRA) can occur in patients with dual chamber pacemakers and is particularly noted in those with intact ventriculoatrial conduction.
  • A 91-year-old female with new cardiomyopathy received an AV synchronous leadless pacemaker, which led to frequent atrial and ventricular pacing issues, identified as PMRA due to changes in heart rates.
  • The study highlights that PMRA may be overlooked in patients with leadless pacemakers, emphasizing the need for further research on its management and impact.
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What are those intermittent "S" waves?

J Electrocardiol

June 2024

Department Internal Medicine, Atrium Health Carolinas Medical Center, Charlotte, NC, USA. Electronic address:

Article Synopsis
  • A 69-year-old woman experienced three fainting spells while on an airplane and was diagnosed with severe bradycardia, indicated by her low heart rate in the thirties.!
  • Two ECGs were performed: the first showed narrow QRS complexes, while the second displayed wide negative deflections after the QRS complexes.!
  • Telemetry recordings allowed doctors to identify the problem's root cause and properly program her implanted pacemaker for treatment.!
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