What is pacemaker syndrome? Cardiology Basics

What is pacemaker syndrome? Cardiology Basics
Pacemaker syndrome is a group of symptoms which can occur in a person implanted with a single chamber ventricular pacemaker. In the normal heart, atria contract first to give a booster filling for the ventricles, followed by the contraction of the ventricles. This is known as atrioventricular (AV) synchrony. When a single chamber pacemaker paces the right ventricle, this AV synchrony is lost and may cause symptoms of pacemaker syndrome.
Persons with pacemaker syndrome may have exertional breathlessness, hypotension and syncope. Easy fatigability, sensation of fullness and pulsations in the head and neck are also features of pacemaker syndrome. When there is no AV synchrony, ventricles do not get the usual help from the atria in filling.
Sometimes both atria and ventricles may contract simultaneously. When the atria and ventricles contract simultaneously due to loss of AV synchrony, the AV valves are closed and does not permit flow of blood from the atria to the ventricles. Then blood from the atria will go back to the veins instead of into the ventricles. This can cause distressing pulsations in the neck. This increases the pressure in atria transiently and can trigger reflex vasodilatation and hypotension leading to syncope.
Pacemaker syndrome can be treated by upgrading to a dual chamber pacemaker. In dual chamber pacing, a right atrial lead is used in addition to the right ventricular lead. Right atrium is paced, followed by th...

Source: Cardiophile MD - October 28, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs