An atrial synchronous ventricular inhibited pulse generator can cause pacemaker-induced tachycardia initiated by premature ventricular beats, which can be resolved by replacing the device.
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Device malfunction should be considered in unexplained pacemaker tachycardia; this single case leaves open its true incidence.
A 68-year-old white male underwent permanent pacemaker implantation with an atrial synchronous ventricular inhibited pulse generator (Medtronic model 2409) because of syncope and abnormal H-V interval of 70 ms. Paroxysmal bouts of pacemaker associated tachycardia were subsequently recorded on several occasions, initiated and terminated by spontaneous ventricular premature beats. The mechanism for the occurrence of the tachyarrhythmia is discussed in detail and the functional characteristics of the pulse generator are described. Replacement of the unit with a different pacer device prevented further occurrence of the arrhythmia.
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Barold et al. (1982) studied this question.
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