Key result
Linking phenomenon in DDD pacemakers can cause functional loss of native AV conduction due to retrograde concealment, resulting in unnecessary right ventricular pacing in 3 patients.
Why the study?
Does the linking phenomenon cause unnecessary right ventricular pacing in DDD pacemaker recipients?
Case Report (n=3)
Does the linking phenomenon cause unnecessary right ventricular pacing in DDD pacemaker recipients?
The linking phenomenon and retrograde concealment should be considered as a potential cause of unnecessary right ventricular pacing in DDD pacemaker recipients.
May explain unexpected RV pacing in DDD recipients; hypothesis-generating case observations leave prevalence and management implications open.
BACKGROUND: The current report describes a manifestation of linking phenomenon in DDD pacemaker recipients: impairment of atrioventricular (AV) conduction and ensuing unnecessary right ventricular (RV) pacing. METHODS: Three patients with second-degree AV block and sudden impairment of native AV conduction following pacemaker implantation are presented. Loss of native AV conduction was considered functional and related to repetitive retrograde invasion of ventricular depolarization to the AV junction that was "linked" to ventricular pacing triggered by nonconducted P-waves. CONCLUSION: This case series demonstrates that linking phenomenon should be considered in analysis of pacemaker behavior, and that retrograde concealment can be responsible for unnecessary RV pacing.
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Marek Jastrzębski (2010) conducted a case report in Second-degree AV block in DDD pacemaker recipients (n=3). DDD pacemaker was evaluated on Impairment of AV conduction and unnecessary RV pacing. Linking phenomenon in DDD pacemakers can cause functional loss of native AV conduction due to retrograde concealment, resulting in unnecessary right ventricular pacing in 3 patients.
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