Ventricular pacemaker with 1:1 retrograde ventriculoatrial (V-A) conduction to the atria (arrows).
Specialty
Cardiology
Pacemaker syndrome is a condition that represents the clinical consequences of suboptimal atrioventricular (AV) synchrony or AV dyssynchrony, regardless of the pacing mode, after pacemaker implantation.[1][2]
It is an iatrogenic disease—an adverse effect resulting from medical treatment—that is often underdiagnosed.[1][3] In general, the symptoms of the syndrome are a combination of decreased cardiac output, loss of atrial contribution to ventricular filling, loss of total peripheral resistance response, and nonphysiologic pressure waves.[2][4][5]
Individuals with a low heart rate prior to pacemaker implantation are more at risk of developing pacemaker syndrome. Normally the first chamber of the heart (atrium) contracts as the second chamber (ventricle) is relaxed, allowing the ventricle to fill before it contracts and pumps blood out of the heart. When the timing between the two chambers goes out of synchronization, less blood is delivered on each beat. Patients who develop pacemaker syndrome may require adjustment of the pacemaker, or fitting of another lead to better coordinate the timing of atrial and ventricular contraction.
^ abEllenbogen KA, Gilligan DM, Wood MA, Morillo C, Barold SS (May 1997). "The pacemaker syndrome -- a matter of definition". Am. J. Cardiol. 79 (9): 1226–9. doi:10.1016/S0002-9149(97)00085-4. PMID 9164889.
^ abChalvidan T, Deharo JC, Djiane P (July 2000). "[Pacemaker syndromes]". Ann Cardiol Angeiol (Paris) (in French). 49 (4): 224–9. PMID 12555483.
^Baumgartner, William A.; Yuh, David D.; Luca A. Vricella (2007). The Johns Hopkins manual of cardiothoracic surgery. New York: McGraw-Hill Medical Pub. ISBN 978-0-07-141652-8.
^Frielingsdorf J, Gerber AE, Hess OM (October 1994). "Importance of maintained atrio-ventricular synchrony in patients with pacemakers". Eur. Heart J. 15 (10): 1431–40. doi:10.1093/oxfordjournals.eurheartj.a060408. PMID 7821326.
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