Pacemaker-Mediated Tachycardia

• Palpitations, fast heartbeats, dizziness, syncope, and discomfort in the chest. 

Hypotension and heart failure symptoms can be brought on by persistent PMT. Book an appointment with your Cardiologist if you experience any of these symptoms or call the emergency number right away if you experience any chest pain or discomfort. 

PMT is dependent on the preset AV delay and the PVARP, and it typically happens at or around the programmed upper rate limit. 

As long as there is ongoing VA conduction and atrial activation outside of the PVARP, this leads to the creation of an unending reentrant arrhythmia circuit. 

Any patient with a dual-chamber pacemaker who exhibits tachycardia should be evaluated for PMT. 

• A physical examination by your cardiologist may be routine and just reveal tachycardia. When an arrhythmia lasts for an extended period of time, hypotension or heart failure symptoms may be visible. 
• An electrocardiogram (EKG) performed during the episodes reveals atrial sensing, A-V association, and ventricular pacing at or just slightly below the upper rate limit. 
• Ventricular pacing at or close to the upper rate limit and the start of the episodes can also be seen on a Holter monitor or event recorder. 

By interrogating the device and reviewing the telemetered intracardiac electrograms, a definitive diagnosis is made. 

• Reprogramming the pacemaker as well as placing a magnet in the pacemaker pocket are two ways to treat pacemaker-mediated tachycardia (PMT). 
• Temporizing techniques, such as carotid massage or AV nodal blockers as drugs (digoxin, beta-blockers, and non-dihydropyridine calcium channel blockers) 
• It may occasionally be necessary to remove the AV node or an auxiliary route from the retrograde conduction pathway. 

Reprogramming the pacemaker to stop pacemaker-mediated tachycardia from recurring is the most effective treatment. 

Consult your Cardiologists about how you might be able to avoid tachycardia caused by pacemakers