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Challenges in Clinical Electrocardiography |

Tachycardia in a Patient With a Dual-Chamber Pacemaker—Discussion

Arch Intern Med. 2011;171(5):380-381. doi:10.1001/archinternmed.2011.60.
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Mattu  ATabas  JABarish  RAElectrocardiography in Emergency Medicine. Dallas, TX American College of Emergency Physicians2007;
Kusumoto  FMGoldschlager  NFCardiac Pacing for the Clinician. 2nd ed. New York, NY Springer Science+Business Media2008;
Sobel  RMDonaldson  PRDhruva  N Pacemaker-mediated tachycardia: management by pacemaker interrogation/reprogramming in the ED. Am J Emerg Med 2002;20 (4) 336- 339
PubMed Link to Article[[XSLOpenURL/10.1053/ajem.2002.33780]]
Griffin  JSmithline  HCook  J Runaway pacemaker: a case report and review. J Emerg Med 2000;19 (2) 177- 181
PubMed Link to Article[[XSLOpenURL/10.1016/S0736-4679(00)00208-0]]
Makaryus  ANPatrick  CMaccaro  P A rare case of “runaway” pacemaker in a modern CPU-controlled pacemaker. Pacing Clin Electrophysiol 2005;28 (9) 993- 996
PubMed Link to Article[[XSLOpenURL/10.1111/pace.2005.28.issue-9]]
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Figure 2.

Enlargement of initial electrocardiogram. This patient had pacemaker-mediated tachycardia near the upper rate limit of 120/min. A pacing stimulus (asterisk) precedes each ventricular complex, and a retrograde P wave (↓P) is seen just after each wide ventricular complex. The P wave axis (upright in aVR and inverted in II) indicates retrograde conduction.

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