Isorhythmic interaction between a dual-chamber pacemaker and an intrinsic rhythm: Pacemaker malfunctioning or not?

Lau, Ernest W.; Harris, Alana; Tang, Antony; Gollob, Michael H.

doi:10.1016/j.hrthm.2004.07.014

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…Various patterns of isorhythmic interaction—a term coined for the dissociation between paced and intrinsic rhythm—were observed during online telemetry 2 . The pattern was dependent on the programmed LRL of the pacemaker in relation to the rate of the automatic junctional rhythm.…”

Section: Discussionmentioning

confidence: 99%

Isorhythmic Dissociation with Smart Sensing in a Dual‐Chamber Implantable Cardioverter Defibrillator

Strohmer

2006

Pacing Clinical Electrophis

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Isorhythmic dissociation is an uncommon but clinically important finding in a patient implanted with a dual chamber cardioverter defibrillator (ICD) capable of SmartSensing. The surface ECG mimicked a malfunction of the pacemaker that was related to the concomitant hemodynamic deterioration. Device interrogation revealed dissociation of the intrinsic junctional and the pacemaker rhythm, which appeared at similar rates. Careful analysis of intracardiac electrograms and marker channel annotations helped to unravel the limitations for physiologic pacing.

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Section: Discussionmentioning

confidence: 99%

Isorhythmic Dissociation with Smart Sensing in a Dual‐Chamber Implantable Cardioverter Defibrillator

Strohmer

2006

Pacing Clinical Electrophis

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“…An E 1 :E 2 ratio of 1:1 usually means E 1 and E 2 are associated but is also compatible with their dissociation, such as during isorhythmic dissociation between an atrial rhythm and an AV junctional rhythm, 8 isorhythmic interaction between an AV junctional rhythm and a pacing device, 9 and DDI pacing.…”

Section: Electrical Association and Dissociationmentioning

confidence: 99%

Infraatrial Supraventricular Tachycardias: Mechanisms, Diagnosis, and Management

Lau

2008

Pacing Clinical Electrophis

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Tachycardias are traditionally classified as either ventricular tachycardia (VT) or supraventricular tachycardia (SVT). VT can be defined as a tachycardia which requires only ventricular structures for perpetuation. SVT is defined in terms of exclusion of VT and hence is any tachycardia which requires participation of at least one supraventricular structure for perpetuation. Certain SVTs require only participation of the atrioventricular node (AVN) and the His bundle (HB) but not the atrial myocardium or any of the great thoracic veins for perpetuation and hence can be described as "infraatrial." The three main mechanisms of infraatrial SVTs are: (1) intranodal atrioventricular reentrant tachycardia; (2) junctional ectopic tachycardia; and (3) nodoventricular reentrant tachycardia. The clinical significance of infraatrial SVTs is that they are compatible with any A:V ratio and even atrioventricular (AV) dissociation. Infraatrial SVTs are often suspected when a narrow complex tachycardia presents with apparent AV dissociation and a counterintuitive A:V ratio of < 1:1. However, if the same tachycardia is conducted with aberrant conduction or preexcitation, a broad complex tachycardia with an A:V ratio of < 1:1 will arise and that can be easily mistaken for VT. The possible patterns of electrical association and dissociation between different cardiac structures are examined, and how individual types of infraatrial SVT can be diagnosed and managed are reviewed.

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Isorhythmic interaction between a dual-chamber pacemaker and an intrinsic rhythm: Pacemaker malfunctioning or not?

Cited by 2 publications

References 2 publications

Isorhythmic Dissociation with Smart Sensing in a Dual‐Chamber Implantable Cardioverter Defibrillator

Isorhythmic Dissociation with Smart Sensing in a Dual‐Chamber Implantable Cardioverter Defibrillator

Infraatrial Supraventricular Tachycardias: Mechanisms, Diagnosis, and Management

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