摘要
Pacemaker mediated tachycardia(PMT)can occur in patients with DDD pacemaker implantation,and PMT in narrow sense is a kind of circular motor tachycardia,which is often caused by ventricular atrial retrograde conduction.This paper reports a case of patients with high atrial pacing value in the early stage of pacemaker implantation,resulting in atrial retrograde conduction and recurrent PMT,Almost non-stop.Although the pacemaker has the PMT automatic termination procedure,PMT is still a short array of repeated attacks due to the presence of poor atrial pacing,resulting in the patients with shortness of breath,lower extremity edema and other heart failure symptoms.Finally,PMT was stopped by prolonging PVARP,and its lower starting frequency was slowed down to 50bpm,and AV interval was kept unchanged for 250ms,so as to reduce the release of atrial pulse and encourage the emergence of self selling down-propagation excitation.The proportion of atrial and ventricular pacing was significantly reduced,which not only saved the electric energy of pacemaker,but also conformed to the physiology.In a narrow sense,pacemaker mediated tachycardia(PMT)is a kind of circular motor tachycardia,which is often caused by reverse ventricular conduction.Repeated attacks for a long time may affect the patient's heart function.Although most modern pacemakers have PMT automatic termination procedures,they are still relatively passive in the presence of some induced factors.Finally,it is necessary to extend PVARP to truly terminate and prevent PM.A case of recurrent PMT due to poor atrial pacing is reported.
