Syncope in a pacemaker patient, uh oh...

Submitted by marc.strik on
Type traces
EGM
Device
PM
Manufacturer
Medtronic

Patient in her sixties had a dual chamber pacemaker implanted in 2015 because of brady-tachy syndrome.

She experienced a syncope and had her pacemaker interrogated at the first heart aid. Below is the EGM during syncope. 

What is the arrhythmia?

Submitted by marc.strik on Mon 25/02/2019 - 16:38

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AVNRT: - PAC (1st AR) with long PR suggests refractory fast pathway and depolarisation of the vemtricles through the slow pathway - 1-to-1 A & V association, we see only ventricular markers but there are clear atrial deflectiins within the PVAB (note that the EGM is atrial)   Since we got her on verapamil we saw no recurrences.