Key result
Pacemaker reprogramming to shorten AV interval and PVARP suppresses drug-refractory pacemaker-mediated common AVNRT.
Why the study?
Drug-refractory common AV nodal reentrant tachycardia in patients with dual chamber pacemakers presents a clinical challenge requiring alternative management strategies.
Case Report (n=1)
No
Pacemaker reprogramming by shortening the sensed AV interval and postventricular atrial refractory period can successfully suppress drug-refractory pacemaker-mediated common AV nodal reentrant tachycardia.
An 81-year-old woman who had undergone dual chamber pacemaker implantation for sick sinus syndrome was referred to our hospital with drug-refractory common atrioventricular (AV) nodal reentrant tachycardia. Ventricular pacing (Vp) following premature atrial contraction (PAC) with a long AV interval induced ventriculoatrial (VA) conduction, which allowed the tachycardia to be initiated. The sensed AV interval was shortened to 80 ms, allowing Vp during the refractory period of VA conduction. Postventricular atrial refractory period was shortened to 180 ms to sense PACs with short coupling interval. After reprogramming, the suppression of the tachycardia by blocking VA conduction following Vp was confirmed.
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Horie et al. (2015) conducted a case report in Drug-refractory pacemaker-mediated common atrioventricular nodal reentrant tachycardia (n=1). Pacemaker reprogramming was evaluated on Suppression of tachycardia. Pacemaker reprogramming by shortening the sensed atrioventricular interval to 80 ms and postventricular atrial refractory period to 180 ms successfully suppressed drug-refractory pacemaker-mediated common AVNRT.
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