Qt-related rate-responsive pacing during acute myocardial infarction.

We studied the findings in a patient who had a TX 915 pacemaker and who was suffering from an acute inferior myocardial infarction. On admission, we observed pacing at the upper rate limit due to excessive adrenergic tone. Shortly thereafter a strong vagal reaction occurred, and the pacing rate fell...

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Detalles Bibliográficos
Publicado en:Pacing & Clinical Electrophysiology Vol. 11; no. 3; pp. 339 - 343
Autores principales: Robbens EJ, Clement DL, Jordaens LJ
Formato: case study Journal Article
Publicado: Wiley-Blackwell Mar1988
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario:We studied the findings in a patient who had a TX 915 pacemaker and who was suffering from an acute inferior myocardial infarction. On admission, we observed pacing at the upper rate limit due to excessive adrenergic tone. Shortly thereafter a strong vagal reaction occurred, and the pacing rate fell back to the lower rate limit. This condition was improved with atropine. Conclusions: (1) In the described condition the TX pacemaker behaved in a very 'physiological' fashion; (2) Sudden strong cholinergic activity lengthened the QT interval; (3) Programming of a steep slope must be avoided in coronary artery disease; (4) Stimulus-T-wave intervals at maximal adrenergic and cholinergic stimulation should be taken into account when programming the slope and the T-wave sensing window.