Episodic ventricular pacing with intact atrioventricular nodal function in a DDDR device: What is the rhythm and how can it be prevented?

Abstract

m A b a t t c v i u. ase summary 67-year-old woman with a history of sick sinus syndrome nderwent placement of a dual-chamber pacemaker in 1993 nd generator change in 2001 (Integrity AFx DR 5342, St. ude Medical, Inc., St. Paul, MN, USA). Pacing was prorammed to DDDR mode with a lower rate limit of 70 ppm, pper rate limit of 120 ppm, and AV delay of 300 ms. While ospitalized for other reasons, she complained of palpitaions that correlated to periods of ventricular pacing. The nset is shown in Figure 1, and the termination is shown in igure 2. What is the explanation for the ventricular pacing? s the pacemaker malfunctioning? What reprogramming can e performed to prevent this rhythm, which is causing the alpitations?