2009
DOI: 10.1093/europace/eup373
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Pseudo-pacemaker syndrome in a young woman with first-degree atrio-ventricular block

Abstract: First-degree atrio-ventricular (AV) block is defined as a PR interval longer than 200 ms. If too long, it can become clinically relevant and may mimic a pacemaker syndrome. We report the case of a young woman with a long PR interval, probably congenital, with episodes of syncope and dizziness since childhood. Pseudo-pacemaker syndrome is rare and is a Class IIa recommendation for a pacemaker implantation. A dual-chamber pacemaker was implanted and short AV delay was programmed, with rapid clinical improvement.

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Cited by 24 publications
(28 citation statements)
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“…Marked First Degree AV Block with extremely prolonged PR interval ≥0.50 s is rare. Most reports on First Degree AV Block quote PR interval which are usually less than 0.50 s [ 5 ]. It has been established that PR interval ≥0.30 s should be classified as class IIa indication for pacing in a symptomatic individual [ 6 ].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Marked First Degree AV Block with extremely prolonged PR interval ≥0.50 s is rare. Most reports on First Degree AV Block quote PR interval which are usually less than 0.50 s [ 5 ]. It has been established that PR interval ≥0.30 s should be classified as class IIa indication for pacing in a symptomatic individual [ 6 ].…”
Section: Discussionmentioning
confidence: 99%
“…It has been established that Marked First Degree AV Block can cause symptoms similar to those produced by Pacemaker Syndrome even without pacemaker and this can occur despite normal left ventricular function. This is what is referred to as Pseudo-Pacemaker Syndrome [ 5 ]. Extremely prolonged PR interval may produce unusual ECG features such as AV Dissociation, a common feature of Third Degree AV Block.…”
Section: Introductionmentioning
confidence: 99%
“…Marked first-degree AV block is a rare but well-recognized cause of the “pseudo-pacemaker syndrome,” whereby atrial systole in close proximity to the preceding ventricular systole leads to various hemodynamic changes, including systemic hypotension, elevated pulmonary arterial pressures, and cannon A-waves 2, 3, 4. Dual AV nodal physiology with preferential antegrade slow pathway conduction can present in a similar fashion 5 .…”
Section: Discussionmentioning
confidence: 99%
“…To date, the treatment of this condition has been dual-chamber pacemaker implantation to restore a physiologic AV interval 2, 3, 4, 5, 6. In case reports and small uncontrolled trials including patients with similar symptoms and with PR intervals >300 ms, this intervention is associated with symptomatic and functional improvement2, 3, 4, 5, 6 and is recommended in the current guidelines for device-based therapies of cardiac rhythm abnormalities (IIa, level of evidence B) 7 …”
Section: Discussionmentioning
confidence: 99%
“…Pseudo-pacemaker syndrome due to a prolonged PR interval is a recognized entity 1 , 2 that can lead to poor exercise tolerance related to atrioventricular (AV) dyssynchrony. This can manifest echocardiographically with diastolic mitral regurgitation (MR).…”
Section: Introductionmentioning
confidence: 99%