- A 60-year-old male with complete heart block received a St Jude's medical pacemaker but later developed heart failure due to tachycardia, identified at 130 beats per minute with pacing spikes.
- Echocardiography revealed left ventricular (LV) dysfunction, which was attributed to tachy-cardiomyopathy, and telemetry data suggested a case of pacemaker-mediated endless loop tachycardia (ELT).
- Reprogramming the pacemaker to extend the post ventricular atrial refractory period (PVARP) successfully terminated the ELT, and the patient’s LV ejection fraction improved within a week.